A new stage of sentinel node navigation surgery in early gastric cancer

被引:21
作者
Fujimura, Takashi [1 ]
Fushida, Sachio [1 ]
Tsukada, Tomoya [1 ]
Kinoshita, Jun [1 ]
Oyama, Katsunobu [1 ]
Miyashita, Tomoharu [1 ]
Takamura, Hiroyuki [1 ]
Kinami, Shinichi [2 ]
Ohta, Tetsuo [1 ]
机构
[1] Kanazawa Univ, Gastroenterol Surg, Kanazawa, Ishikawa 9208641, Japan
[2] Kanazawa Med Univ, Gen & Digest Surg, Uchinada, Ishikawa 92002, Japan
关键词
Sentinel node navigation surgery; Lymphatic basin; Selective lymphadenectomy; Function-preserving gastrectomy; PYLORUS-PRESERVING GASTRECTOMY; INDOCYANINE GREEN INJECTION; POSTOPERATIVE EVALUATION; MULTICENTER TRIAL; MICROMETASTASES; RESECTION; BIOPSY; LYMPHADENECTOMY; DISSECTION; FUTURE;
D O I
10.1007/s10120-014-0446-z
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Sentinel node (SN) navigation surgery is expected to realize organ- and function-preserving surgery with SN mapping, and has been applied in operations for breast cancer and melanoma. But there has been no definite evidence for the SN concept in gastric cancer. A prospective multicenter trial to confirm the SN concept for gastric cancer conducted by the Japan Society of Sentinel Node Navigation Surgery reported that the SN detection rate, sensitivity of positive SNs, and accuracy of nodal status are 97.5 % (387/397), 93 % (53/57), and 99 % (383/387), respectively. A detailed analysis of the trial suggested that strictly the "lymphatic basin concept" rather than the "SN concept" was confirmed in early gastric cancer. The Japan Society of Sentinel Node Navigation Surgery started a new trial of function-preserving gastrectomy with lymphatic basin dissection (LBD) for early gastric cancer without metastasis in SNs on the basis of this promising outcome of the trial. It is supposed that LBD guarantees curability in SN navigation surgery for early gastric cancer. Full-thickness resection or endoscopic submucosal dissection in combination with laparoscopic LBD will soon be a new treatment option for early gastric cancer.
引用
收藏
页码:210 / 217
页数:8
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