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Updated: May 8, 2026
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan
Yuko Kitagawa1, Hiroya Takeuchi, Yu Takagi
1Yuko Kitagawa, Hiroya Takeuchi, and Masaki Kitajima, Keio University School of Medicine; Yu Takagi, Tokyo Medical University, Tokyo; Shoji Natsugoe, Yoshikazu Uenosono, and Takashi Aikou, Kagoshima University Graduate School of Medical Science, Kagoshima; Masanori Terashima, Fukushima Medical University, Fukushima; Nozomu Murakami, Ishikawa Prefectural Central Hospital; Takashi Fujimura, Shinichi Kinami, and Koichi Miwa, Kanazawa University Hospital, Ishikawa; Hironori Tsujimoto, National Defense Medical College; Nobunari Yoshimizu, Saitama Social Insurance Hospital, Saitama; Hideki Hayashi, Graduate School of Medicine, Chiba University, Chiba; Akinori Takagane, Iwate Medical University, Iwate; Yasuhiko Mohri, Mie University Graduate School of Medicine, Mie; Kazuhito Nabeshima, Tokai University; Satoshi Morita, Yokohama City University Graduate School of Medicine, Kanagawa; and Junichi Sakamoto, Nagoya University Graduate School of Medicine, Aichi, Japan.
Purpose:
Complicated gastric lymphatic drainage potentially undermines the utility of sentinel node (SN) biopsy in patients with gastric cancer. Encouraged by several favorable single-institution reports, we conducted a multicenter, single-arm, phase II study of SN mapping that used a standardized dual tracer endoscopic injection technique.
Patients And Methods:
Patients with previously untreated cT1 or cT2 gastric adenocarcinomas < 4 cm in gross diameter were eligible for inclusion in this study. SN mapping was performed by using a standardized dual tracer endoscopic injection technique. Following biopsy of the identified SNs, mandatory comprehensive D2 or modified D2 gastrectomy was performed according to current Japanese Gastric Cancer Association guidelines.
Results:
Among 433 patients who gave preoperative consent, 397 were deemed eligible on the basis of surgical findings. SN biopsy was performed in all patients, and the SN detection rate was 97.5% (387 of 397). Of 57 patients with lymph node metastasis by conventional hematoxylin and eosin staining, 93% (53 of 57) had positive SNs, and the accuracy of nodal evaluation for metastasis was 99% (383 of 387). Only four false-negative SN biopsies were observed, and pathologic analysis revealed that three of those biopsies were pT2 or tumors > 4 cm. We observed no serious adverse effects related to endoscopic tracer injection or the SN mapping procedure.
Conclusion:
The endoscopic dual tracer method for SN biopsy was confirmed as safe and effective when applied to the superficial, relatively small gastric adenocarcinomas included in this study.
