Sentinel lymph node mapping for 385 gastric cancer patients

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Sentinel lymph node (SLN) biopsy is being explored for early gastric cancer staging.
• The SLN concept shows potential for clinical T1N0M0 or T2N0M0 gastric cancer with tumors ≤4 cm.

Purpose of the Study:

• Investigate the accuracy of SLN biopsy in gastric cancer.
• Identify predictors for false-negative SLN cases.
• Evaluate indications for SLN-navigated gastrectomy.
• Characterize challenges in SLN mapping for gastric cancer.

Main Methods:

• 385 patients with cT1N0M0 or cT2aN0M0 gastric cancer underwent gastrectomy with SLN mapping (radio-guided and dye-guided).
• Multivariate regression analysis was used to examine predictors of undetected or false-negative SLN cases.

Main Results:

• The SLN detection rate was 96.6%, with an overall accuracy of 98.9% for metastatic status.
• Accuracy was 99.1% for cT1 and 96.0% for cT2 gastric cancer.
• False-negative cases often involved deeper tumor invasion; positive SLN status correlated with worse survival.

Conclusions:

• The SLN concept is validated for early gastric cancer (cT1, ≤4 cm tumor diameter).
• SLN mapping offers effective lymph node staging for minimized gastrectomy.
• Sentinel basin dissection prevents leaving positive lymph nodes; procedural experience can reduce errors.