Assessment of lymphatic flow based on the sentinel node concept in early gastric adenocarcinoma that satisfies expanded endoscopic resection criteria

Masashi Takeuchi, Hirofumi Kawakubo, Ayako Shimada, Satoru Matsuda, Tadaki Nakahara, Shuhei Mayanagi, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, Norihito Wada, Hiroya Takeuchi, Yuko Kitagawa

研究成果: Article

抄録

Background: Even though indications for endoscopic resection (ER) in early gastric cancer are determined based on the potential risk of lymph node metastasis, the criteria for ER remain controversial. Sentinel node (SN) mapping for early gastric cancer can help determine regional lymphatic flow patterns. The aim of this study was to assess lymphatic flow according to the SN concept in patients with early gastric cancer, especially those who satisfy the expanded criteria for ER. Methods: We retrospectively enrolled 301 patients diagnosed with pT1 adenocarcinoma who had undergone gastrectomy with SN mapping and had no lymphovascular invasion. Patients were categorized into six groups based on oncological assessment. We analyzed lymphatic flow, including the number of identified SN and SN basin, and the rate of SN metastasis in each group. Results: Of the 301 patients, 128 (42.5%) met the criteria for ER, with 18 in the absolute group and 110 in the expanded group; 173 (57.5%) were assigned to the surgical group. SN metastasis rate tended to be higher in surgical group patients than in ER criteria patients. In the expanded criteria group, the sub-group of patients with intramucosal, undifferentiated adenocarcinoma measuring 20 mm or less had a significantly greater number of identified SNs (p = 0.013) and SN basins (p = 0.032). Furthermore, SN metastasis was observed only in this group. Conclusions: Patients with intramucosal, nonulcerated, undifferentiated adenocarcinoma measuring 20 mm or less could develop a lymphatic network. For these patients, careful follow-up is required after ER.

元の言語English
ジャーナルGastric Cancer
DOI
出版物ステータスAccepted/In press - 2019 1 1

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Stomach
Adenocarcinoma
Neoplasm Metastasis
Stomach Neoplasms
cyhalothrin
Gastrectomy
Lymph Nodes

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

これを引用

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title = "Assessment of lymphatic flow based on the sentinel node concept in early gastric adenocarcinoma that satisfies expanded endoscopic resection criteria",
abstract = "Background: Even though indications for endoscopic resection (ER) in early gastric cancer are determined based on the potential risk of lymph node metastasis, the criteria for ER remain controversial. Sentinel node (SN) mapping for early gastric cancer can help determine regional lymphatic flow patterns. The aim of this study was to assess lymphatic flow according to the SN concept in patients with early gastric cancer, especially those who satisfy the expanded criteria for ER. Methods: We retrospectively enrolled 301 patients diagnosed with pT1 adenocarcinoma who had undergone gastrectomy with SN mapping and had no lymphovascular invasion. Patients were categorized into six groups based on oncological assessment. We analyzed lymphatic flow, including the number of identified SN and SN basin, and the rate of SN metastasis in each group. Results: Of the 301 patients, 128 (42.5{\%}) met the criteria for ER, with 18 in the absolute group and 110 in the expanded group; 173 (57.5{\%}) were assigned to the surgical group. SN metastasis rate tended to be higher in surgical group patients than in ER criteria patients. In the expanded criteria group, the sub-group of patients with intramucosal, undifferentiated adenocarcinoma measuring 20 mm or less had a significantly greater number of identified SNs (p = 0.013) and SN basins (p = 0.032). Furthermore, SN metastasis was observed only in this group. Conclusions: Patients with intramucosal, nonulcerated, undifferentiated adenocarcinoma measuring 20 mm or less could develop a lymphatic network. For these patients, careful follow-up is required after ER.",
keywords = "Endoscopic mucosal resection, Sentinel lymph node biopsy, Stomach neoplasms",
author = "Masashi Takeuchi and Hirofumi Kawakubo and Ayako Shimada and Satoru Matsuda and Tadaki Nakahara and Shuhei Mayanagi and Tomoyuki Irino and Kazumasa Fukuda and Rieko Nakamura and Norihito Wada and Hiroya Takeuchi and Yuko Kitagawa",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s10120-019-01026-7",
language = "English",
journal = "Gastric Cancer",
issn = "1436-3291",
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TY - JOUR

T1 - Assessment of lymphatic flow based on the sentinel node concept in early gastric adenocarcinoma that satisfies expanded endoscopic resection criteria

AU - Takeuchi, Masashi

AU - Kawakubo, Hirofumi

AU - Shimada, Ayako

AU - Matsuda, Satoru

AU - Nakahara, Tadaki

AU - Mayanagi, Shuhei

AU - Irino, Tomoyuki

AU - Fukuda, Kazumasa

AU - Nakamura, Rieko

AU - Wada, Norihito

AU - Takeuchi, Hiroya

AU - Kitagawa, Yuko

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Even though indications for endoscopic resection (ER) in early gastric cancer are determined based on the potential risk of lymph node metastasis, the criteria for ER remain controversial. Sentinel node (SN) mapping for early gastric cancer can help determine regional lymphatic flow patterns. The aim of this study was to assess lymphatic flow according to the SN concept in patients with early gastric cancer, especially those who satisfy the expanded criteria for ER. Methods: We retrospectively enrolled 301 patients diagnosed with pT1 adenocarcinoma who had undergone gastrectomy with SN mapping and had no lymphovascular invasion. Patients were categorized into six groups based on oncological assessment. We analyzed lymphatic flow, including the number of identified SN and SN basin, and the rate of SN metastasis in each group. Results: Of the 301 patients, 128 (42.5%) met the criteria for ER, with 18 in the absolute group and 110 in the expanded group; 173 (57.5%) were assigned to the surgical group. SN metastasis rate tended to be higher in surgical group patients than in ER criteria patients. In the expanded criteria group, the sub-group of patients with intramucosal, undifferentiated adenocarcinoma measuring 20 mm or less had a significantly greater number of identified SNs (p = 0.013) and SN basins (p = 0.032). Furthermore, SN metastasis was observed only in this group. Conclusions: Patients with intramucosal, nonulcerated, undifferentiated adenocarcinoma measuring 20 mm or less could develop a lymphatic network. For these patients, careful follow-up is required after ER.

AB - Background: Even though indications for endoscopic resection (ER) in early gastric cancer are determined based on the potential risk of lymph node metastasis, the criteria for ER remain controversial. Sentinel node (SN) mapping for early gastric cancer can help determine regional lymphatic flow patterns. The aim of this study was to assess lymphatic flow according to the SN concept in patients with early gastric cancer, especially those who satisfy the expanded criteria for ER. Methods: We retrospectively enrolled 301 patients diagnosed with pT1 adenocarcinoma who had undergone gastrectomy with SN mapping and had no lymphovascular invasion. Patients were categorized into six groups based on oncological assessment. We analyzed lymphatic flow, including the number of identified SN and SN basin, and the rate of SN metastasis in each group. Results: Of the 301 patients, 128 (42.5%) met the criteria for ER, with 18 in the absolute group and 110 in the expanded group; 173 (57.5%) were assigned to the surgical group. SN metastasis rate tended to be higher in surgical group patients than in ER criteria patients. In the expanded criteria group, the sub-group of patients with intramucosal, undifferentiated adenocarcinoma measuring 20 mm or less had a significantly greater number of identified SNs (p = 0.013) and SN basins (p = 0.032). Furthermore, SN metastasis was observed only in this group. Conclusions: Patients with intramucosal, nonulcerated, undifferentiated adenocarcinoma measuring 20 mm or less could develop a lymphatic network. For these patients, careful follow-up is required after ER.

KW - Endoscopic mucosal resection

KW - Sentinel lymph node biopsy

KW - Stomach neoplasms

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U2 - 10.1007/s10120-019-01026-7

DO - 10.1007/s10120-019-01026-7

M3 - Article

C2 - 31728803

AN - SCOPUS:85075086994

JO - Gastric Cancer

JF - Gastric Cancer

SN - 1436-3291

ER -