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Potential for local resection with sentinel node basin dissection for early gastric cancer based on the distribution of primary sites

  • Junya Aoyama
  • Hirofumi Kawakubo
  • Osamu Goto
  • Tadaki Nakahara
  • Shuhei Mayanagi
  • Kazumasa Fukuda
  • Koichi Suda
  • Rieko Nakamura
  • Norihito Wada
  • Hiroya Takeuchi
  • Yuko Kitagawa
Original Article

Abstract

Background

Based on the sentinel node (SN) concept, function-preserving surgery with SN basin dissection (SNBD) can be performed for SN-negative early gastric cancers. Particularly, a resection area can be minimized when the SN basin and primary site are closely localized. The aim of this study was to compare probabilities of being candidates for local resection with SNBD based on tumor location among patients with early gastric cancer.

Methods

We retrospectively analyzed 358 patients who underwent surgery with SN mapping for gastric cancer in our institution from November 1999 to April 2014. The proportion of patients who had a localized single basin and the distributions of the SN basins and primary sites were investigated. Patients with single basin drainage excluding remote sentinel node basin were considered as candidates for local resection with SNBD.

Results

Of the 358 patients, 191 (53%) patients were considered eligible for local resection with SNBD. Patients with tumors located in the upper third of the stomach were more likely candidates for local resection than those with tumors in other locations (upper third, 68%; middle third, 50%; and lower third, 51%), whereas patients with tumors located in the anterior wall were less likely candidates than those with tumors other locations (anterior wall, 31%; posterior wall, 58%; greater curvature, 55%; and lesser curvature, 57%).

Conclusion

We found that > 50% of the patients indicated for SN navigation surgery, particularly those with tumors in the upper third of the stomach, potentially could undergo partial resection with SNBD.

Keywords

Minimally invasive surgery Sentinel node navigation surgery Local resection Early gastric cancer 

Notes

Compliance with ethical standards

Ethical approval

All the procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients for inclusion in the study.

Conflict of interest

Yuko Kitagawa received designated donation from Daiichi Sankyo Co., Ltd.

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  • Junya Aoyama
    • 1
  • Hirofumi Kawakubo
    • 1
  • Osamu Goto
    • 2
  • Tadaki Nakahara
    • 3
  • Shuhei Mayanagi
    • 1
  • Kazumasa Fukuda
    • 1
  • Koichi Suda
    • 1
  • Rieko Nakamura
    • 1
  • Norihito Wada
    • 1
  • Hiroya Takeuchi
    • 1
    • 4
  • Yuko Kitagawa
    • 1
  1. 1.Department of SurgerySchool of Medicine, Keio UniversityTokyoJapan
  2. 2.Department of GastroenterologyNippon Medical SchoolTokyoJapan
  3. 3.Department of RadiologyKeio University School of MedicineTokyoJapan
  4. 4.Department of SurgeryHamamatsu University School of MedicineHamamatsuJapan

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