Tailoring treatment for early gastric cancer after endoscopic resection using sentinel node navigation with infrared ray electronic endoscopy combined with indocyanine green injection.
BACKGROUND
This study evaluated the efficacy of sentinel node navigation surgery using infrared ray electronic endoscopy (IREE) combined with indocyanine green in patients after endoscopic treatments of early gastric cancer.


METHODS
14 patients with early gastric cancer after endoscopic treatments were included. Each patient underwent sentinel node navigation surgery using IREE. Sentinel node detection rate, accuracy of sentinel node metastases and clinical efficacy including the presence or absence of recurrence were evaluated.


RESULTS
The intraoperative sentinel node detection rate was 100% (14/14), and accuracy for sentinel node metastases was 93% (13/14). Based on the results of sentinel node mapping, 2 patients received standard gastrectomy with D2 lymphadenectomy, and the remaining 12 patients underwent limited surgery with lymphatic basin dissection. After median follow-up of 32 months, no patients had tumor recurrence.


CONCLUSIONS
The validity of limited surgery based on sentinel node navigation for early gastric cancer remains unclear because the results of a well-designed multicenter clinical trial of sentinel node mapping for gastric cancer have not yet been reported. However, this study suggests that sentinel node navigation surgery using IREE combined with indocyanine green is useful for early gastric cancer after endoscopic resection.
Ohdaira
Hironori
H
Department of Surgery, Jikei University School of Medicine, Kashiwa Kenshin Clinic, Tokyo 105-8461, Japan. ohdaira@iuhw.ac.jp
Nimura
Hiroshi
H
Fujita
Tetsuji
T
Mitsumori
Norio
N
Takahashi
Naoto
N
Kashiwagi
Hideyuki
H
Narimiya
Norichika
N
Yanaga
Katsuhiko
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D055088:Early Detection of Cancer / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D007208:Indocyanine Green; D007259:Infrared Rays; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D004396:Coloring Agents; D007208:Indocyanine Green