Prediction of lymph nodes metastasis by sentinel node biopsy in gastric cancer

The application of sentinel node (SN) biopsy in gastric cancer remains controversial. In this study, detection rate and predictive values of SN biopsy were determined to evaluate its feasibility in gastric cancer. Various clinicopathologic features were also analysed to determine the factors affecting the detection rate and predictive values.

Seventy-one gastric adenocarcinoma patients without serosal invasion and distant metastasis, were studied. One percent isosulfan blue stained nodes were defined as SNs, and standard gastrectomy with D2 lymphadenectomy was performed. All lymph nodes were studied by hematoxylin and eosin staining.

SNs were identified in 65 of 71 patients and average number of SNs per patient was 2.5 (range 1-8). Among the 65 patients with SNs, metastatic SNs were found in 11 and the remaining 54 were free of metastasis. In eight of the 11 patients with metastasis of the SNs, metastases were also identified in non-SNs.

SN biopsy is feasible in early stage gastric cancer. However, complementary procedures may be needed to improve the detection rate and predictive values. SNs biopsy results should be treated with caution in male patients and for tumours at the upper part of stomach due to the low detection rate.