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| Item Type: | Article |
|---|---|
| Title: | Efficacy of Different Technical Procedures for Sentinel Lymph Node Biopsy in Gastric Cancer Staging |
| Creators Name: | Gretschel, S., Bembenek, A., Huenerbein, M., Dresel, S., Schneider, W. and Schlag, P.M. |
| Abstract: | Background: The clinical impact of sentinel lymph node biopsy (SLNB) in gastric cancer is controversial. We performed a prospective trial to compare different methods: radiocolloid method (RM), dye method (DM), and both methods simultaneously (dual method, or DUM) for reliability and therapeutic consequences. Methods: RM and DM were applied in 35 gastric cancer patients. After endoscopic peritumoral injection of (99m)Tc-colloid and Patent Blue V, the positions of all blue sentinel lymph nodes (SLNs) were recorded, and the SLNs microscopically examined by hematoxylin and eosin, step sections, and immunohistochemistry. Results: RM, DM, and DUM identified the SLNs in 34 (97%) of 35 patients. The sensitivity for the prediction of positive lymph node status for RM was 22 (92%) of 24, for DM 16 (66%) of 24, and for DUM 22 (92%) of 24. In 7 of 17 (RM), 5 of 15 (DM), and 7 of 17 (DUM) patients classified as N0 by routine hematoxylin and eosin staining, micrometastases or isolated tumor cells were found in the SLN (upstaging) after focused examination. If only a limited lymph node dissection of the SLN basins would have been performed in patients, residual lymph node metastases were left in 9 of 24 (RM), in 7 of 34 (DM), and in 5 of 24 (DUM) of patients with node-positive disease. Conclusions: Use of RM was superior. DUM did not further increase the sensitivity. A limited lymph node dissection-i.e., lymphatic basin in patients with SLN-positive disease-is associated with a high risk of residual metastases. Patients with negative SLNs may be selected for a limited surgical procedure if they meet certain criteria. |
| Keywords: | Gastric cancer, Sentinel lymph node biopsy, Dye method, Radiocolloid method |
| Source: | Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Volume: | 14 |
| Number: | 7 |
| Page Range: | 2028-2035 |
| Date: | July 2007 |
| Official Publication: | https://doi.org/10.1245/s10434-007-9367-y |
| PubMed: | View item in PubMed |
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