title: Clinical study of harvesting lymph nodes with carbon nanoparticles in advanced gastric cancer: a prospective randomized trial.
abstract: BACKGROUND
  The objective of this study is to evaluate the efficiency and safety of carbon nanoparticles (CNPs) for harvesting lymph nodes (LNs) in cases of advanced gastric cancer (AGC).
  
  
  METHODS
  Patients with previously untreated resectable AGC were eligible for inclusion in this study. All patients were randomly allocated to two subgroups. In the experimental group, 1.0 mL of CNP was injected into the subserosa of the stomach around the tumor before gastrectomy with D2 dissection. The same procedure was performed directly without any coloring material in the control arm. Following surgery, LNs were harvested, colored LNs were counted, and the diameters were measured by the investigator and pathologist.
  
  
  RESULTS
  Thirty patients were enrolled in the study. We observed no serious adverse effects related to CNP injection. The rate of stained LNs was 46.6%. The mean number of harvested LNs was larger in the experimental than in the control group (38.33 vs 28.27, p = 0.041). A smaller diameter of LNs was recorded in the experimental arm (3.32 vs 4.30 mm, p = 0.023). In addition, we developed a model for predicting the total number of LNs based on the data from CNP-stained LNs and metastatic LNs (MLNs).
  
  
  CONCLUSIONS
  CNP is a safe material. Surgeons could harvest more LNs in patients with AGC. The harvest of an increased number of smaller diameters of LNs may be beneficial. Further study is warranted to demonstrate the model's practicality.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Ziyu
authors.initials: Z
authors.lastname: Li
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.|Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Lian-Hua-Lu Street, Shenzhen, People's Republic of China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Ao
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Zhaode
authors.initials: Z
authors.lastname: Bu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Aiwen
authors.initials: A
authors.lastname: Wu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Xiaojiang
authors.initials: X
authors.lastname: Wu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Shan
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ji
authors.affiliation: Department of Medical Statistics, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China.
authors.forename: Zhaodong
authors.initials: Z
authors.lastname: Xing
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Fu-Cheng-Lu Street, Beijing, People's Republic of China. jiafuji2000@163.com.|Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, People's Republic of China. jiafuji2000@163.com.
authors.forename: Jiafu
authors.initials: J
authors.lastname: Ji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon / Q000737:chemistry*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053758:Nanoparticles / Q000008:administration & dosage* / Q000737:chemistry; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D002244:Carbon
keywords: Advanced gastric cancer; Carbon nanoparticles; D2 gastrectomy; LN harvesting