Learning Curve for Identification of Sentinel Lymph Node Based on a Cumulative Sum Analysis in Gastric Cancer

被引:20
作者
Lee, J. H. [1 ]
Ryu, K. W. [1 ]
Lee, S. E. [1 ]
Cho, S. J. [1 ]
Lee, J. Y. [1 ]
Kim, C. G. [1 ]
Choi, I. J. [1 ]
Kook, M. C. [1 ]
Kim, M. J. [1 ]
Park, S. R. [1 ]
Lee, J. S. [1 ]
Nam, B. H. [2 ]
Kim, Y. W. [1 ]
机构
[1] Natl Canc Ctr, Gastr Canc Branch, Goyang, South Korea
[2] Natl Canc Ctr, Canc Biostat Branch, Res Inst Natl Canc Control & Evaluat, Goyang, South Korea
关键词
Gastric cancer; Sentinel lymph node mapping; Learning curve; Cumulative sum analysis; COMPUTED-TOMOGRAPHY; HOSPITAL MORTALITY; GASTRECTOMY; BIOPSY; CARCINOMA; LAPAROSCOPY; RESECTION; OUTCOMES; SURGERY;
D O I
10.1159/000236036
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Lymph node metastasis is the most important point to consider when deciding on the modality of resection in patients with early gastric cancer. This study was conducted to evaluate the learning curve for identification of sentinel lymph nodes in patients with gastric cancer. Methods: The investigators included the results from 2 prospective series of sentinel lymph node mapping. Cumulative sum (CUSUM) analysis was performed to assess the learning curves for identification of sentinel lymph nodes at CUSUM target success rates of 95%. Results: One surgeon performed 135 sentinel lymph node mappings for 2 prospective series. The success rate exceeded 90%. The learning period for gastric cancer sentinel node mapping was calculated to be 26 cases for achieving a 95% success rate. Multiple logistic regression analysis for successful detection of sentinel nodes showed that surgical experience of sentinel lymph node mapping was an independent factor for successful detection of sentinel nodes. Conclusions: This study suggests that the learning period for identification of sentinel lymph nodes in gastric cancer would be 26 cases. In clinical trials for gastric cancer with sentinel lymph node mapping, the learning curve should be considered to minimize bias due to surgical factors. Copyright (C) 2010 S. Karger AG, Basel
引用
收藏
页码:465 / 470
页数:6
相关论文
共 32 条
[1]   Micrometastases in sentinel nodes of gastric cancer [J].
Ajisaka, H ;
Miwa, K .
BRITISH JOURNAL OF CANCER, 2003, 89 (04) :676-680
[2]   Effect of distal subtotal gastrectomy with preservation of the celiac branch of the vagus nerve to gastrointestinal function - An experimental study in conscious dogs [J].
Ando, Hiroyuki ;
Mochiki, Erito ;
Ohno, Tetsuro ;
Kogure, Norimichi ;
Tanaka, Naritaka ;
Tabe, Yuichi ;
Kimura, Hitoshi ;
Kamiyama, Yoichi ;
Aihara, Ryuusuke ;
Nakabayashi, Toshihiro ;
Asao, Takayuki ;
Aomori, Tohru ;
Fujita, Yukiyoshi ;
Kuwano, Hiroyuki .
ANNALS OF SURGERY, 2008, 247 (06) :976-986
[3]  
[Anonymous], INT UNION CANC TNM C
[4]   Sentinel node staging of resectable colon cancer - Results of a multicenter study [J].
Bertagnolli, M ;
Miedema, B ;
Redston, M ;
Dowell, J ;
Niedzwiecki, D ;
Fleshman, J ;
Bem, J ;
Mayer, R ;
Zinner, M ;
Compton, C .
ANNALS OF SURGERY, 2004, 240 (04) :624-628
[5]   Influence of surgical subspecialty training on in-hospital mortality for gastrectomy and colectomy patients [J].
Callahan, MA ;
Christos, PJ ;
Gold, HT ;
Mushlin, AI ;
Daly, JM .
ANNALS OF SURGERY, 2003, 238 (04) :629-636
[6]   Spiral computed tomography and operative staging of gastric carcinoma: a comparison with histopathological staging [J].
Davies, J ;
Chalmers, AG ;
SueLing, HM ;
May, J ;
Miller, GV ;
Martin, IG ;
Johnston, D .
GUT, 1997, 41 (03) :314-319
[7]  
EAGON JC, 1992, SURG CLIN N AM, V72, P445
[8]  
GOULD EA, 1960, CANCER, V13, P77, DOI 10.1002/1097-0142(196001/02)13:1<77::AID-CNCR2820130114>3.0.CO
[9]  
2-D
[10]  
*JAP RES SOC GASTR, 1995, JAP CLASS GASTR CARC, P1