Clinical Aspect: Esophageal Cancer
If the sentinel node (SN) concept is established for esophageal cancer, SN navigation surgery will be clinically useful. The following personalized treatments will also be possible: reducing the extent of lymphadenectomy in upper mediastinal and cervical regions, targeting radiotherapy for SN, and SN sampling with endoscopic therapy. Since difficulties are associated with using the dye method for the detection of SN due to complex lymphatic flow in the esophagus and anthracosis in the lymph nodes, the radioisotope method is available for esophageal cancer. When SN navigation surgery is introduced in the clinical field, an accurate diagnosis is essential for nodal metastasis, including micrometastasis. Only a few studies have been published on the SN concept for esophageal cancer, and clinical evidence is currently not available. In our experience, the SN concept is applicable to patients with cT1 and cN0 esophageal cancer; however, the role of SN navigation surgery for clinical T2 or more remains unclear. Multicenter trials are needed in the near future in order to establish standard personalized therapy.
KeywordsSentinel node Esophageal cancer Lymph node metastasis Micrometastasis Minimally invasive surgery
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