Recent advances in sentinel node navigation for gastric cancer: a paradigm shift of surgical management.

Abstract:

:The sentinel node (SN) is defined as the first draining node from the primary lesion and it has proven to be a good indicator of the metastatic status of regional lymph nodes in solid tumors. In the past 5 years, the validity of SN concept for gastric cancer has been demonstrated by a number of single institutional studies. Using a dual tracer method as the optimal procedure, the radio-guided method allows us to confirm the complete harvest of SNs by gamma probing, while the dye procedure enables us to perform real time observation of the lymphatic vessels. From previous reports, clinically staged T1N0 gastric cancer seems to be a good entity on which to try to change the therapeutic approach based on SN biopsy. At present, two large scale prospective multicenter trials are on-going in Japan. To overcome some remaining issues, such as limited sensitivity of intra-operative diagnosis of metastasis, and technical difficulty in laparoscopic SN detection, further technical and instrumental developments will be required. During this transitional phase, focused lymph node dissection targeted to sentinel lymphatic basins and modified resection of the stomach is an acceptable approach. Although there are several remaining issues, SN navigation should provide a paradigm shift for the surgical management of early gastric cancer in near future.

journal_name

J Surg Oncol

authors

Kitagawa Y,Fujii H,Kumai K,Kubota T,Otani Y,Saikawa Y,Yoshida M,Kubo A,Kitajima M

doi

10.1002/jso.20220

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

147-51; discussion 151-2

issue

3

eissn

0022-4790

issn

1096-9098

journal_volume

90

pub_type

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