Solitary lymph node metastasis of gastric cancer as a basis for sentinel lymph node biopsy.
OBJECTIVE
In order to examine the biology of sentinel lymph node of stomach cancer, we investigated solitary lymph node metastases that were hypothesized to represent sentinel lymph node.


METHODS
In the 4,620 primary gastric cancers between 1964 and 1997, 1271 cases with a localized tumor were selected and the localization of the solitary metastases in relation to the primary tumors were studied.


RESULTS
Of the 130 tumors with a single basin metastasis, only 71% of the tumors in the upper third, 75% of the middle and 80% of the lower involved the node basins in the close vicinity. In the anterior wall and the greater curvature the rates of adjacent metastasis were more than 90%, while in the posterior wall and the lesser curvature they were 76% and 43%, respectively. Metastases of the remaining cases were found at more distant basins.


CONCLUSIONS
In stomach cancer sensitivity of sentinel lymph node biopsy would be very low by the exploration of the adjacent basin especially for the lesions in the lesser curvature and posterior wall.
Tsuburaya
Akira
A
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2, Nakao, Asahi-ku, Yokohama 2410815, Japan. tsubu@lares.dti.ne.jp
Noguchi
Yoshikazu
Y
Yoshikawa
Takaki
T
Kobayashi
Osamu
O
Sairenji
Motonori
M
Motohashi
Hisahiko
H
D000230:Adenocarcinoma / Q000473:pathology*; D002288:Adenocarcinoma, Mucinous / Q000473:pathology; D002291:Carcinoma, Papillary / Q000473:pathology*; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology; D006801:Humans; D009361:Neoplasm Invasiveness; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000473:pathology*