title: The feasibility of sentinel lymph node biopsy for gastric cancer: the experience from Serbia.
abstract: OBJECTIVE
  The prediction of outcome for patients with gastric cancer is determined largely by the presence of lymph node metastases, which could be detected by sentinel lymph node (SLN) biopsy (SLNB). The purpose of this work was to determine the feasibility of SLNB in patients with gastric cancer for the assessment of regional lymph node status, including performing immunohistochemical (IHC) staining of SLN tissue.
  
  
  METHODS
  We reviewed 137 consecutive patients with operable gastric cancer over a 10-year period using a retrospective (to examine skip metastases) and prospective (to evaluate successful mapping) study design. SLNs were mapped, biopsied and subsequently explored by routine hematoxylin & eosin (H&E) staining and by IHC staining using a cytokeratin 8/18 antibody.
  
  
  RESULTS
  The retrospective study showed a low incidence of skip metastases (3.7%). Mapping of SLNs in the prospective study was highly successful (98.2%). During the prospective study, IHC examination of SLNs from 56 patients showed statistically significant change in disease stage.
  
  
  CONCLUSIONS
  This study demonstrated highly successful mapping and biopsy of SLNs (98.2%), as well as highest specificity (100%), sensitivity (100%) and accuracy (100%) to predict metastasis in the surrounding lymph nodes of gastric carcinoma. In addition, we believe that IHC study might enable "ultra staging" and additional selection of patients for further cancer treatment.
authors.affiliation: Department of Surgery, University of Belgrade, Belgrade, Serbia.
authors.forename: D
authors.initials: D
authors.lastname: Stojanovic
authors.forename: S M
authors.initials: SM
authors.lastname: Milenkovic
authors.forename: N
authors.initials: N
authors.lastname: Mitrovic
authors.forename: D
authors.initials: D
authors.lastname: Marinkovic
authors.forename: D
authors.initials: D
authors.lastname: Stevanovic
authors.forename: D
authors.initials: D
authors.lastname: Radovanovic
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053538:Keratin-18 / Q000032:analysis; D053533:Keratin-8 / Q000032:analysis; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D055771:Serbia; D013274:Stomach Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; C488421:KRT18 protein, human; C426203:KRT8 protein, human; D053538:Keratin-18; D053533:Keratin-8