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Updated: Jul 14, 2026
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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Sentinel node sampling limits lymphadenectomy in stage I non-small cell lung cancer
Masashi Muraoka1, Shinji Akamine, Tadayuki Oka
1Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. mmuraoka@lucky.odn.ne.jp
Summary
This study suggests a less invasive approach for stage I lung cancer by using sentinel lymph node sampling. This method can help avoid extensive mediastinal lymph node dissection in select patients.
Area of Science:
- Oncology
- Thoracic Surgery
Background:
- Systematic mediastinal lymph node dissection (MLND) in stage I lung cancer is debated.
- Sentinel lymph node (SLN) hypothesis based on primary tumor lobe may refine staging and treatment.
Purpose of the Study:
- To evaluate a novel sentinel lymph node (SLN) mapping strategy based on primary tumor lobe in stage I non-small cell lung cancer (NSCLC).
- To assess the feasibility of omitting systematic MLND when SLNs are metastasis-free.
Main Methods:
- Two studies were conducted: 1) Assessing LN metastases in 291 stage I NSCLC patients undergoing MLND. 2) Performing lobectomy with SLN sampling in 64 patients with preoperative complications, omitting MLND if SLNs were negative.
- SLN mapping varied by lobe: right upper (3, 4, 10), middle (4, 7, 10), left upper (5, 6, 10), and lower lobes (7, 10, 11). Pleural invasion was an exclusion criterion for the second study.
Main Results:
- In the first study, 6/291 patients had skip metastases, 5 with pleural invasion.
- In the second study (median follow-up 39 months), 11/64 patients had metastatic LNs. 53/64 (83%) patients avoided MLND due to negative SLNs.
- The SLN sampling group had 36% morbidity, no mortality, 82% 5-year survival, with low recurrence rates (2 local, 8 distant, 1 carcinomatous pleuritis).
Conclusions:
- Intra-operative SLN sampling is a viable strategy for less invasive lymphadenectomy in select stage I NSCLC patients.
- This approach may reduce surgical morbidity without compromising survival outcomes.
