Sentinel Node Mapping for Gastric Cancer: A Prospective Multicenter Trial in Japan

被引：259

作者：

Kitagawa, Yuko ^{[1
]}

Takeuchi, Hiroya ^{[1
]}

Takagi, Yu ^{[2
]}

Natsugoe, Shoji ^{[3
]}

Terashima, Masanori ^{[4
]}

Murakami, Nozomu ^{[5
]}

Fujimura, Takashi ^{[6
]}

Tsujimoto, Hironori ^{[7
]}

Hayashi, Hideki ^{[9
]}

Yoshimizu, Nobunari ^{[8
]}

Takagane, Akinori ^{[10
]}

Mohri, Yasuhiko ^{[11
]}

Nabeshima, Kazuhito ^{[12
]}

Uenosono, Yoshikazu ^{[3
]}

Kinami, Shinichi ^{[6
]}

Sakamoto, Junichi ^{[14
]}

Morita, Satoshi ^{[13
]}

Aikou, Takashi ^{[3
]}

Miwa, Koichi ^{[6
]}

Kitajima, Masaki ^{[1
]}

机构：

[1] Keio Univ, Sch Med, Tokyo 1608582, Japan

[2] Tokyo Med Univ, Tokyo 1608402, Japan

[3] Kagoshima Univ, Grad Sch Med Sci, Kagoshima 890, Japan

[4] Fukushima Med Univ, Fukushima, Japan

[5] Ishikawa Prefectural Cent Hosp, Kanazawa, Ishikawa, Japan

[6] Kanazawa Univ Hosp, Kanazawa, Ishikawa, Japan

[7] Natl Def Med Coll, Tokorozawa, Saitama, Japan

[8] Saitama Social Insurance Hosp, Saitama, Japan

[9] Chiba Univ, Grad Sch Med, Chiba, Japan

[10] Iwate Med Univ, Morioka, Iwate, Japan

[11] Mie Univ, Grad Sch Med, Tsu, Mie, Japan

[12] Tokai Univ, Hiratsuka, Kanagawa 25912, Japan

[13] Yokohama City Univ, Grad Sch Med, Yokohama, Kanagawa, Japan

[14] Nagoya Univ, Grad Sch Med, Nagoya, Aichi 4648601, Japan

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2013年 / 31卷 / 29期

关键词：

LYMPH-NODE; BIOPSY; DIAGNOSIS; MELANOMA;

D O I：

10.1200/JCO.2013.50.3789

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose Complicated gastric lymphatic drainage potentially undermines the utility of sentinel node (SN) biopsy in patients with gastric cancer. Encouraged by several favorable single-institution reports, we conducted a multicenter, single-arm, phase II study of SN mapping that used a standardized dual tracer endoscopic injection technique. Patients and Methods Patients with previously untreated cT1 or cT2 gastric adenocarcinomas < 4 cm in gross diameter were eligible for inclusion in this study. SN mapping was performed by using a standardized dual tracer endoscopic injection technique. Following biopsy of the identified SNs, mandatory comprehensive D2 or modified D2 gastrectomy was performed according to current Japanese Gastric Cancer Association guidelines. Results Among 433 patients who gave preoperative consent, 397 were deemed eligible on the basis of surgical findings. SN biopsy was performed in all patients, and the SN detection rate was 97.5% (387 of 397). Of 57 patients with lymph node metastasis by conventional hematoxylin and eosin staining, 93% (53 of 57) had positive SNs, and the accuracy of nodal evaluation for metastasis was 99% (383 of 387). Only four false-negative SN biopsies were observed, and pathologic analysis revealed that three of those biopsies were pT2 or tumors > 4 cm. We observed no serious adverse effects related to endoscopic tracer injection or the SN mapping procedure. Conclusion The endoscopic dual tracer method for SN biopsy was confirmed as safe and effective when applied to the superficial, relatively small gastric adenocarcinomas included in this study.

引用

页码：3704 / +

页数：8

共 24 条

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