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Sentinel Lymph Node Biopsy in Cancers of the Gastrointestinal Tract

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Radioguided Surgery

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Abstract

Despite the significant clinical contribution of the sentinel lymph node concept to the effective treatment in melanoma and breast cancer (1),(2), most surgeons have reserved judgment on its applicability to upper gastrointestinal (GI) malignancies (3),(4), mainly due to multidirectional lymphatic flow from the gastrointestinal tract and the widespread and random patterns of lymph node metastasis in GI malignancies. Anatomic skip metastases were found in 50% to 60% of esophageal cancers and 20% to 30% of gastric cancers in a retrospective analysis of the location of solitary metastases (5),(6). Sano et al. reported that the perigastric nodal area close to the primary tumor is the first site of metastasis in only 62% of gastric cancers, based on a retrospective analysis of cases of solitary metastasis (7). In cases of lower rectal cancer, a relatively high incidence of lateral lymph node metastasis, including skip metastasis, has been reported (8). Based on these clinical observations, extended radical procedures such as esophagectomy with 3-field lymph node dissection, gastrectomy with D2 lymphadenectomy, and extended lymphadenectomy with lateral node dissection for rectal cancer have become standard surgical treatment in Japan, even for clinically node negative cases (9)–(11).

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Author information

Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Yuko Kitagawa MD, PhD, FACS & Masaki Kitajima MD, PhD, FACS

  2. Department of Surgery and Anatomy, College of Human Medicine and Department of Surgery, Michigan State University, USA

    Sukamal Saha MD, FACS, FRCS

  3. McLaren Regional Medical Center, Flint, MI, USA

    Sukamal Saha MD, FACS, FRCS

Authors
  1. Yuko Kitagawa MD, PhD, FACS
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  2. Sukamal Saha MD, FACS, FRCS
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  3. Masaki Kitajima MD, PhD, FACS
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Editor information

Editors and Affiliations

  1. Regional Center of Nuclear Medicine, University of Pisa Medical School, Pisa, Italy

    Giuliano Mariani MD

  2. John Wayne Cancer Institute, Saint John’s Health Center, Santa Monica, California, USA

    Armando E. Giuliano MD (Chief of Science and Medicine) (Chief of Science and Medicine)

  3. Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    H. William Strauss MD

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© 2008 Springer Science+Business Media, LLC

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Kitagawa, Y., Saha, S., Kitajima, M. (2008). Sentinel Lymph Node Biopsy in Cancers of the Gastrointestinal Tract. In: Mariani, G., Giuliano, A.E., Strauss, H.W. (eds) Radioguided Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-38327-9_14

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  • DOI: https://doi.org/10.1007/978-0-387-38327-9_14

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-33684-8

  • Online ISBN: 978-0-387-38327-9

  • eBook Packages: MedicineMedicine (R0)

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