title: A new stage of sentinel node navigation surgery in early gastric cancer.
abstract: Sentinel node (SN) navigation surgery is expected to realize organ- and function-preserving surgery with SN mapping, and has been applied in operations for breast cancer and melanoma. But there has been no definite evidence for the SN concept in gastric cancer. A prospective multicenter trial to confirm the SN concept for gastric cancer conducted by the Japan Society of Sentinel Node Navigation Surgery reported that the SN detection rate, sensitivity of positive SNs, and accuracy of nodal status are 97.5% (387/397), 93% (53/57), and 99% (383/387), respectively. A detailed analysis of the trial suggested that strictly the "lymphatic basin concept" rather than the "SN concept" was confirmed in early gastric cancer. The Japan Society of Sentinel Node Navigation Surgery started a new trial of function-preserving gastrectomy with lymphatic basin dissection (LBD) for early gastric cancer without metastasis in SNs on the basis of this promising outcome of the trial. It is supposed that LBD guarantees curability in SN navigation surgery for early gastric cancer. Full-thickness resection or endoscopic submucosal dissection in combination with laparoscopic LBD will soon be a new treatment option for early gastric cancer.
authors.affiliation: Gastroenterologic Surgery, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan, tphuji@staff.kanazawa-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Tomoya
authors.initials: T
authors.lastname: Tsukada
authors.forename: Jun
authors.initials: J
authors.lastname: Kinoshita
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Oyama
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Miyashita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D055088:Early Detection of Cancer; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008198:Lymph Nodes / Q000473:pathology*; D011379:Prognosis; D011788:Quality of Life; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*