Feasibility and efficacy of sentinel lymph node mapping in gastric cancer Journal Article
| Authors: | Abate, M.; Drebin, H.; Shimada, S.; Fei, T.; McKinley, S.; Poruk, K.; Ferguson, B.; Neuwirth, M.; Tang, L. H.; Vardhana, S.; Strong, V. E. |
| Article Title: | Feasibility and efficacy of sentinel lymph node mapping in gastric cancer |
| Abstract: | Background: Lymph node metastasis is a critical prognostic factor for patients with gastric carcinoma (GC). Sentinel lymph node (SLN) mapping has the potential to identify the initial site of draining lymph node metastasis and reduce the extent of surgical lymphadenectomy. This study aimed to evaluate the diagnostic accuracy of SLN mapping in GC. Methods: The study enrolled 129 GC patients undergoing total or partial gastrectomy with D2 lymphadenectomy and indocyanine green fluorescence-guided SLN mapping. The primary outcomes were the negative predictive value (NPV) and sensitivity of SLN mapping. The secondary outcomes were clinicopathologic factors associated with SLN mapping accuracy and successful SLN mapping. Results: The SLN detection rate in this study was 86.8 %. The study had an overall NPV of 83.1 % and an overall sensitivity of 65.8 %. The NPV was found to be significantly higher in the patients with no lymphovascular invasion (LVI) than in those with LVI (96.0 % vs 59.3 %; p < 0.001) and in the patients whose pathologic T (pT) stage lower than 3 than in those whose T stage was 3 or higher (92.0 % vs 66.7 %; p = 0.009). The sensitivity of SLN mapping was 50 % in the patients with no LVI and 33 % in the patients with a pT stage lower than 3. Conclusion: The study results showed that for patients with early-stage GC with no LVI, negative SLN findings may represent a potential additive predictor indicating the absence of regional LN metastasis. However, given the low sensitivity rates noted, further research is needed to identify specific patient populations that may benefit from SLN mapping in GC. © Society of Surgical Oncology 2024. |
| Keywords: | adult; controlled study; human tissue; aged; aged, 80 and over; middle aged; major clinical study; histopathology; cancer localization; cancer staging; outcome assessment; follow up; follow-up studies; lymph node metastasis; lymph node dissection; lymphatic metastasis; neoplasm staging; sentinel lymph node mapping; diagnostic accuracy; preoperative evaluation; sensitivity and specificity; sentinel lymph node; lymph node excision; sentinel lymph node biopsy; lymphadenectomy; adenocarcinoma; tumor volume; aspiration; cohort analysis; kidney failure; pathology; retrospective study; distant metastasis; lung embolism; false negative result; feasibility study; feasibility studies; surgical infection; surgery; gastrectomy; neoplasm invasiveness; ex vivo study; perioperative complication; urine retention; stomach carcinoma; stomach neoplasms; wound closure; predictive value; fluorescence imaging; serosa; stomach tumor; caucasian; brain edema; partial gastrectomy; anastomosis leakage; asian; minimally invasive procedure; tumor invasion; procedures; total gastrectomy; coloring agents; skin incision; coloring agent; acidosis; stomach paresis; open surgery; indocyanine green; lymph vessel metastasis; distal gastrectomy; very elderly; humans; prognosis; human; male; female; article; tumor depth; robot assisted surgery; draining lymph node; confusion matrix; draining lymph node metastasis |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-10-01 |
| Start Page: | 6959 |
| End Page: | 6969 |
| Language: | English |
| DOI: | 10.1245/s10434-024-15642-w |
| PUBMED: | 39097552 |
| PROVIDER: | scopus |
| PMCID: | PMC11977517 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Vivian E. Strong -- Source: Scopus |
