J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3383KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 102(10): 753-757, 2001

Feature topic

CLINICAL SIGNIFICANCE OF SENTINEL NODE NAVIGATION SURGERY IN THE TREATMENT OF EARLY GASTRIC CANCER

1) Department of Surgery, Keio University School of Medicine, Tokyo, Japan
2) Department of Radiology, Keio University School of Medicine, Tokyo, Japan
3) Department of Pathology, Keio University School of Medicine, Tokyo, Japan

Yuko Kitagawa1), Tetsuro Kubota1), Yoshihide Otani1), Toshiharu Furukawa1), Masashi Yoshida1), Hirofumi Fujii2), Atsushi Kubo2), Makio Mukai3), Koichiro Kumai1), Masaki Kitajima1)

Radical lymphadenectomy is the standard surgicai approach even for early-stage gastric cancer with a relatively low incidence of lymph node metastasis because of the limited sensitivity of diagnostic imaging to detect micrometastasis in regional lymph nodes. The sentinel node (SN) concept is one topic among novel diagnostic procedures for micrometastasis. The SN is defined as the first draining node from the primary lesion and it would be the first site of micrometastasis. SN biopsy has been clinically validated and applied for the surgical treatment of malignant melanoma and breast cancer. Although the feasibility of this technique in other solid tumors including gastric cancer is still controversial, there are several reports demonstrating the diagnostic significance of SN mapping in early gastric cancer. We have established radio-guided SN mapping for early gastric cancer, and the diagnostic accuracy using this procedure in cT1N0 cases reached 98%. The radio-guided method allows us to detect the SN in endoscopic surgery quantitatively and reproducibly. Validation of the SN concept in gastric cancer in a multi-centric clinical trial is essential for clinical application of this procedure, including the esta. blishment of a novel, minimally invasive approach for early-stage gastric cancer.

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