title: Value of sentinel lymph node mapping using a blue dye-only method in gastric cancer: a single-center experience from North-East Hungary.
abstract: BACKGROUND
  Forty percent of patients with gastric cancer have unnecessarily extended lymph node dissections with higher rates of morbidity and mortality than those in non-extended procedures. Successful sentinel lymph node (SLN) mapping may help to reduce the number of extended lymphadenectomies.
  
  
  METHODS
  SLN mapping was investigated by a blue dye-only method in patients with gastric cancer. The first cohort of patients (n = 16) were marked submucosally by an endoscopist and in the second cohort of patients (n = 23) a subserosal injection was performed by the surgeon.
  
  
  RESULTS
  Thirty-nine patients, all Caucasians, underwent gastric resection or total gastrectomy with SLN biopsy using patent blue-dye mapping and modified D2 lymphadenectomy. The mapping procedure and the lymphadenectomy were supervised by the same surgeon. A total of 770 lymph nodes were removed and examined. The mean number of blue nodes was 4.3 per patient. In 22/23 cases at least one SLN showed tumor involvement. The sensitivity of SLN mapping was 95.7%, the false-negative rate was 4.3%, and the specificity was 100%. The negative predictive value was 93.8% and the positive predictive value was 100%. In cases of T1 and T2 tumors the sensitivity was 100%. We found the two marking methods (submucosal vs. subserosal) to be equivalent and there was no side-effect of the blue-dye mapping.
  
  
  CONCLUSIONS
  Our results suggest that SLN mapping with blue dye alone represents a safe procedure that seems to be adaptable for non-obese patients undergoing open surgery for gastric cancer in the Eastern European region. The procedure has high sensitivity and specificity, especially in cases of T1 and T2 tumors.
authors.affiliation: Department of General Surgery, Kenézy Teaching Hospital, 2-26 Bartók Street, Debrecen, Hungary. detoth@gmail.com
authors.forename: Dezso
authors.initials: D
authors.lastname: Tóth
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Kincses
authors.forename: János
authors.initials: J
authors.lastname: Plósz
authors.forename: Miklós
authors.initials: M
authors.lastname: Török
authors.forename: Ilona
authors.initials: I
authors.lastname: Kovács
authors.forename: Csongor
authors.initials: C
authors.lastname: Kiss
authors.forename: László
authors.initials: L
authors.lastname: Damjanovich
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005188:False Negative Reactions; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006814:Hungary; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D004396:Coloring Agents