title: Sentinel node mapping and skip metastases in patients with early gastric cancer.
abstract: 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.
authors.affiliation: Gastric Cancer Branch, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, South Korea.
authors.forename: Sang Eok
authors.initials: SE
authors.lastname: Lee
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Myung Cherl
authors.initials: MC
authors.lastname: Kook
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.forename: Sook Ryun
authors.initials: SR
authors.lastname: Park
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
mesh_terms: 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