Abstract
Background. Sentinel node (SN) biopsy has been tried in the management of a variety of cancers
with the hope that it would eliminate many unnecessary lymph node dissections, resulting
in less morbidity. This important technique, however, has not been tried in gastric
cancer surgery. The feasibility of SN biopsy and its accuracy in predicting the lymph
node status in patients with gastric cancer were examined in the current study. Patients and Methods. SN biopsy was performed in patients with T1 (n = 44) or T2 (n = 30) gastric cancers
(ie, immediately after laparotomy, indocyanine green was injected around the primary
tumor, and the green-stained nodes [SNs: 2.6 ± 1.7 nodes per patient] were removed).
Then, gastrectomy with extended lymphadenectomy was performed. The unstained nodes
(non-SNs: 39 ± 18 nodes per patient) were obtained from the resected specimens. Both
SNs and non-SNs were subjected to histologic examination with hematoxylin-eosin. Results. SNs could be identified in 73 of 74 patients (success rate, 99%). Of these 73 patients,
10 had lymph node metastases in SNs or non-SNs, or both; 6 in both SNs and non-SNs;
3 in SNs alone; and 1 in non-SNs alone. The sensitivity of the SN status in the diagnosis
of the lymph node status of the patient was 90% (9/10) and specificity was 100% (63/63).
Sensitivity was 100% in the T1 group (n = 44) and 88% in the T2 group (n = 29). Conclusions. SN biopsy using indocyanine green can be performed with a high success rate, and
the SN status can predict the lymph node status with a high degree of accuracy, especially
in patients with T1 gastric cancer. (Surgery 2001;129:335-40.)
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Article info
Publication history
Accepted:
September 10,
2000
Footnotes
☆Reprint requests: Masahiro Hiratsuka, MD, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases; 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
☆☆Surgery 2001;129:335-40.
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
