Sentinel node mapping and skip metastases in patients with early gastric cancer.
OBJECTIVE
This study was designed to identify the characteristics of patients with early gastric cancers that have skip metastases.


BACKGROUND
The possibility of lymph node metastasis is the most important factor to consider when deciding on the resection procedure for patients with early gastric cancer.


METHODS
From February 2003 through July 2008, 739 patients with early gastric adenocarcinoma underwent gastric resection at the National Cancer Center, Korea, and were included in this study. Patients with skip metastases were analyzed and compared with those without skip metastases.


RESULTS
Skip metastases were found in 2.8% of patients with early gastric cancer. Tumor size and the presence of lymphatic invasion were associated with skip metastases by both univariate and multivariate analysis. All skip metastases were metastases to the extraperigastric lymph nodes that skipped across the perigastric lymph nodes. Sixteen patients (66.7%) with these metastases had metastatic lymph nodes at No. 7, 8, and 9 stations.


CONCLUSIONS
Tumor size should be considered during sentinel lymph node mapping to prevent false-negative results in patients with early gastric cancer. If sentinel nodes are not found in the perigastric lymph nodes, No. 7, 8, and 9 stations should be explored for prevention of false-negative sentinel node mapping results.
Lee
Sang Eok
SE
Gastric Cancer Branch, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, South Korea.
Lee
Jun Ho
JH
Ryu
Keun Won
KW
Cho
Soo Jeong
SJ
Lee
Jong Yeul
JY
Kim
Chan Gyoo
CG
Choi
Il Ju
IJ
Kook
Myung Cherl
MC
Nam
Byung-Ho
BH
Park
Sook Ryun
SR
Lee
Jong Seok
JS
Kim
Young-Woo
YW
D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007723:Korea; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D055815:Young Adult