Intraoperative lymphatic mapping and sentinel lymph node sampling in esophageal and gastric cancer.
Recent studies for SN mapping of esophageal and gastric carcinoma show that the SN concept is valid even for upper GI cancers with multidirectional and complicated lymphatic flow. The relatively high incidence of anatomic skip metastasis can be attributed to aberrant distribution of SNs. An individualized and minimally invasive surgical approach can be applicable to management of esophageal and gastric carcinoma based on SN status. Although there are several issues to be resolved, this novel procedure has the potential for great benefit to improve quality control in the treatment of upper GI cancer. Well-designed clinical trials of lymphatic mapping for upper GI cancer will be essential to determine whether this technique is widely applicable in the management of these tumors.
Kitagawa
Yuko
Y
Department of Surgery, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582. kitagawa@sc.itc.keio.ac.jp
Fujii
Hirofumi
H
Mukai
Makio
M
Kubota
Tetsuro
T
Ando
Nobutoshi
N
Ozawa
Soji
S
Ohtani
Yoshihide
Y
Furukawa
Toshiharu
T
Yoshida
Masashi
M
Nakamura
Eiichi
E
Matsuda
Jun-ichi
J
Shimizu
Yoshimasa
Y
Nakamura
Kayoko
K
Kumai
Koichiro
K
Kubo
Atsushi
A
Kitajima
Masaki
M
D004938:Esophageal Neoplasms / Q000473:pathology*; D006801:Humans; D007432:Intraoperative Period; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology*