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Related Experiment Videos

Sentinel node concept in gastric carcinoma.

Takashi Ichikura1, Daisaku Morita, Takefumi Uchida

  • 1Department of Surgery I, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa 359-8513, Japan.

World Journal of Surgery
|February 28, 2002
PubMed
Summary
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Sentinel lymph node mapping in gastric cancer shows promise for identifying metastasis. However, indocyanine green lymphatic mapping may miss some cancerous nodes, especially those fully occupied by tumor cells.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • The sentinel lymph node (SLN) concept is crucial in staging various cancers.
  • Its applicability to gastric carcinoma requires further investigation due to complex lymphatic drainage.

Purpose of the Study:

  • To evaluate the feasibility and accuracy of sentinel node biopsy in gastric cancer patients.
  • To assess the utility of indocyanine green (ICG) lymphatic mapping for identifying metastatic lymph nodes.

Main Methods:

  • Retrospective analysis of 119 gastric carcinoma patients with limited metastasis.
  • Intraoperative lymphatic mapping using endoscopic submucosal injection of ICG in 62 patients.
  • Analysis of metastatic lymph node distribution and correlation with ICG staining.

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Main Results:

  • Metastatic lymph nodes outside the perigastric area were found in 4% of patients with single-node metastasis.
  • ICG lymphatic mapping was successful in all patients.
  • No metastasis was observed in 96% of patients without metastasis in green-stained nodes.
  • Nodes completely occupied by cancer may not be detected by ICG mapping.

Conclusions:

  • Lymphatic mapping with ICG is a viable tool for sentinel node identification in gastric cancer.
  • The complex lymphatic drainage of the stomach necessitates careful interpretation of SLN biopsy results.
  • Limitations exist, particularly in detecting lymph nodes heavily infiltrated by cancer.