Sentinel node navigation surgery in early-stage esophageal cancer.
The sentinel node (SN) concept has revolutionized the surgical staging of both melanoma and breast cancer over the past two decades. However, the validity of the SN hypothesis has been controversial for esophageal cancer, because SN mapping for esophageal cancer is technically complicated, and the number of early-stage esophageal cancer is very limited. Nevertheless previous studies nicely demonstrated that SN mapping may be feasible in patients with early-stage esophageal cancer. Transthoracic extended esophagectomy with three-field radical lymph node dissection has been recognized as a curative procedure for thoracic esophageal cancer in Japan. However, uniform application of this highly invasive procedure might increase the morbidity and markedly reduce the quality of life (QOL) after surgery. Although further accumulation of evidence based on multicenter clinical trials using a standard protocol is needed, SN mapping and SN navigation surgery would provide significant information to perform individualized selective lymphadenectomy which might reduce the morbidity and retain the patients' QOL. In addition, technical innovation including the development of new tracers is expected to confirm the accuracy and reliability of SN mapping in esophageal cancer.
Department of Surgery, Keio University School of Medicine, Tokyo, Japan. htakeuchi@a6.keio.jp
Hiroya
H
Takeuchi
Hirofumi
H
Kawakubo
Flavio
F
Takeda
Tai
T
Omori
Yuko
Y
Kitagawa
D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D011788:Quality of Life; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D016896:Treatment Outcome
D019275:Radiopharmaceuticals