Sentinel node mapping for post-endoscopic resection gastric cancer: multicenter retrospective cohort study in Japan

Japanese Society for Sentinel Node Navigation Surgery

Research output: Contribution to journalArticle

Abstract

Background: Standard gastrectomy with systematic lymphadenectomy as an additional surgery after endoscopic resection (ER) causes a deterioration in long-term quality of life. If the sentinel lymph node (SN) basin concept can be applied in post-ER gastric cancer, minimal surgery can be applied without reducing the curability. This retrospective multicenter cohort study aimed to verify the validity of the SN basin concept in post-ER gastric cancer. Patients and methods: Individual data of 132 patients who underwent SN mapping after ER were collected from 8 university hospitals in Japan from 2001 to 2016. Tracers were injected endoscopically in the submucosal layer at four sites around the post-ER scar. We compared the SN basin distribution of post-ER gastric cancer with that of 275 patients with non-ER gastric cancer. Results: Two cases of SN were unidentified, both involving a single tracer (SN detection rate: 98.5%). Nine cases (6.8%) of lymph node metastasis were found, of which eight had a metastatic lymph node within the SNs and one had a non-SN metastasis within the SN basin. The diagnostic sensitivity of SN mapping for lymph node metastasis was 88.9% in post-ER group and 95.7% in non-ER group (P = 0.490); the accuracy was 99.2% and 99.6% (P = 0.539), respectively. Regarding the SN basin, no significant intergroup differences were found regardless of the primary tumor location. Conclusions: Our findings clarified the feasibility of SN mapping based on the SN basin concept in patients with gastric cancer who previously underwent ER.

Original languageEnglish
JournalGastric Cancer
DOIs
Publication statusAccepted/In press - 2020 Jan 1

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Keywords

  • Early gastric cancer
  • Endoscopic mucosal resection
  • Endoscopic submucosal dissection
  • Sentinel lymph node

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

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