Skip to main content
SpringerLink
Log in

Gastrointestinal Cancer and the Lymphatic System: Patterns of Micrometastasis and Lymphatic Mapping with Clinical Outcome

  • Chapter
  • First Online:
From Local Invasion to Metastatic Cancer

Part of the book series: Current Clinical Oncology ((CCO))

  • 931 Accesses

Abstract

Precise evaluation of lymph node status is the most important factor for determining clinical outcome in treating gastrointestinal (GI) cancer. Unfortunately, lymph node metastasis (MA) may not always be accurately assessed through a preoperative work-up. Because lymphatic drainage of the GI tract is much more complicated than other anatomical sites, skip MA occurs rather frequently. Currently, sentinel lymph node (SLN) mapping has become highly feasible and accurate for staging GI cancer, and has clearly developed into a new therapeutic modality

The diagnosis of nodal MA, including micrometastasis (MM) using immunohistochemical and molecular technology, has been nearly achieved through GI cancer surgery. Furthermore, the sixth edition of the tumor node metastasis (TNM) classification has recently been redefined as “sentinel nodes (SN),” “micrometastasis (MM; 0.2–2 mm in diameter),” and “isolated tumor cells” (ITC; <0.2 mm). The clinical significance of MM or ITC in SNs may differ among various organs. In particular, the prognostic value of MM detected by molecular technology remains controversial.

The purpose of this symposium was to focus on the present status of SN navigation surgery in the three major types of GI cancers (esophagus, stomach, and colon), as well as to discuss the clinical significance of SLN biopsy, including the prognostic value of lymph node MA and MM identified in SN. The clinical impact of circulating tumor cells (CTCs) or bone marrow aspirates was also discussed.

All speakers showed favorable results for identifying the GI SLN. Thus, accurate detection and diagnosis of lymph node MA including MM in SLNs has achieved a selection of more sophisticated, tailor-made approaches in clinical practice.

Presented at the 2nd International Symposium on Cancer Metastasis and the Lymphovascular System, May 5, 2007, San Francisco, CA.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Aikou T, Kitagawa Y, Kitajima M, et al. Sentinel lymph node mapping with GI cancer. Cancer Metastasis Rev 2006; 25(2):269–77.

    Article  PubMed  Google Scholar 

  2. Cuschieri A, Shimi S, Banting S, Vander Velpen G. Endoscopic ultrasonic dissection for thoracoscopic and laparoscopic surgery. Surg Endosc 1993; 7(3):197–9.

    Article  PubMed  CAS  Google Scholar 

  3. Gossot D, Fourquier P, Celerier M. Thoracoscopic esophagectomy: technique and initial results. Ann Thorac Surg 1993; 56(3):667–70.

    Article  PubMed  CAS  Google Scholar 

  4. Kitagawa Y, Ohgami M, Fujii H, et al. Laparoscopic detection of sentinel lymph nodes in gastrointestinal cancer: a novel and minimally invasive approach. Ann Surg Oncol 2001; 8(9 Suppl):86S–9S.

    PubMed  CAS  Google Scholar 

  5. Uenosono Y, Natsugoe S, Higashi H, et al. Evaluation of colloid size for sentinel nodes detection using radioisotope in early gastric cancer. Cancer Lett 2003; 200(1):19–24.

    Article  PubMed  CAS  Google Scholar 

  6. Uenosono Y, Natsugoe S, Ehi K, et al. Detection of sentinel nodes and micrometastases using radioisotope navigation and immunohistochemistry in patients with gastric cancer. Br J Surg 2005; 92(7):886–9.

    Article  PubMed  CAS  Google Scholar 

  7. Kitagawa Y, Fujii H, Mukai M, et al. Radio-guided sentinel node detection for gastric cancer. Br J Surg 2002; 89(5):604–8.

    Article  PubMed  CAS  Google Scholar 

  8. Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial. J Clin Oncol 2001; 19(4):1128–36.

    PubMed  CAS  Google Scholar 

  9. Saha S, Wiese D, Badin J, et al. Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging. Ann Surg Oncol 2000; 7(2):120–4.

    Article  PubMed  CAS  Google Scholar 

  10. Itabashi M, Yoshida K, Kameoka S. [Sentinel node navigation surgery for colorectal cancer]. Gan To Kagaku Ryoho 2005; 32(4):557–60.

    PubMed  Google Scholar 

  11. Braat AE, Oosterhuis JW, Moll FC, de Vries JE. Successful sentinel node identification in colon carcinoma using Patent Blue V. Eur J Surg Oncol 2004; 30(6):633–7.

    Article  PubMed  CAS  Google Scholar 

  12. Covarelli P, Cristofani R, Boselli C, et al. Preliminary study on radioguided sentinel node identification in colon cancer. Am Surg 2007; 73(3):222–6.

    PubMed  Google Scholar 

  13. Bilchik AJ, Trocha SD. Lymphatic mapping and sentinel node analysis to optimize laparoscopic resection and staging of colorectal cancer: an update. Cancer Control 2003; 10(3):219–23.

    PubMed  Google Scholar 

  14. Natsugoe S, Matsumoto M, Okumura H, et al. Initial metastatic, including micrometastatic, sites of lymph nodes in esophageal squamous cell carcinoma. J Surg Oncol 2005; 89(1):6–11.

    Article  PubMed  Google Scholar 

  15. Tanabe T, Nishimaki T, Watanabe H, et al. Immunohistochemically detected micrometastasis in lymph nodes from superficial esophageal squamous cell carcinoma. J Surg Oncol 2003; 82(3):153–9.

    Article  PubMed  Google Scholar 

  16. Matsuda J, Kitagawa Y, Fujii H, et al. Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer. Ann Surg Oncol 2004; 11(3 Suppl):250S–4S.

    PubMed  Google Scholar 

  17. Higashi H, Natsugoe S, Ishigami S, et al. Distribution of lymph node metastasis including micrometastasis in gastric cancer with submucosal invasion. World J Surg 2003; 27(4):455–9.

    Article  PubMed  Google Scholar 

  18. Yanagita S, Natsugoe S, Uenosono Y, et al. Morphological distribution of metastatic foci in sentinel lymph nodes with gastric cancer. Ann Surg Oncol 2008; 15(3):770–6.

    Article  PubMed  Google Scholar 

  19. Stojadinovic A, Nissan A, Protic M, et al. Prospective randomized study comparing sentinel lymph node evaluation with standard pathologic evaluation for the staging of colon carcinoma: results from the United States Military Cancer Institute Clinical Trials Group Study GI-01. Ann Surg 2007; 245(6):846–57.

    Article  PubMed  Google Scholar 

  20. Paramo JC, Summerall J, Poppiti R, Mesko TW. Validation of sentinel node mapping in patients with colon cancer. Ann Surg Oncol 2002; 9(6):550–4.

    Article  PubMed  Google Scholar 

  21. Saha S, Monson KM, Bilchik A, et al. Comparative analysis of nodal upstaging between colon and rectal cancers by sentinel lymph node mapping: a prospective trial. Dis Colon Rectum 2004; 47(11):1767–72.

    Article  PubMed  Google Scholar 

  22. Joosten JJ, Strobbe LJ, Wauters CA, et al. Intraoperative lymphatic mapping and the sentinel node concept in colorectal carcinoma. Br J Surg 1999; 86(4):482–6.

    Article  PubMed  CAS  Google Scholar 

  23. Bertagnolli M, Miedema B, Redston M, et al. Sentinel node staging of resectable colon cancer: results of a multicenter study. Ann Surg 2004; 240(4):624–8; discussion 628–30.

    PubMed  Google Scholar 

  24. Natsugoe S, Mueller J, Stein HJ, et al. Micrometastasis and tumor cell microinvolvement of lymph nodes from esophageal squamous cell carcinoma: frequency, associated tumor characteristics, and impact on prognosis. Cancer 1998; 83(5):858–66.

    Article  PubMed  CAS  Google Scholar 

  25. Matsumoto M, Natsugoe S, Nakashima S, et al. Clinical significance of lymph node micrometastasis of pN0 esophageal squamous cell carcinoma. Cancer Lett 2000; 153(1–2):189–97.

    Article  PubMed  CAS  Google Scholar 

  26. Jiao X, Eslami A, Ioffe O, et al. Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer. Ann Thorac Surg 2003; 76(4):996–9; discussion 999–1000.

    Article  PubMed  Google Scholar 

  27. Bonavina L, Incarbone R, Midolo V, et al. [Prognostic significance of lymphatic micrometastasis of esophageal adenocarcinoma]. Chir Ital 2004; 56(2):189–96.

    PubMed  Google Scholar 

  28. Kim JH, Park JM, Jung CW, et al. The significances of lymph node micrometastasis and its correlation with E-cadherin expression in pT1-T3N0 gastric adenocarcinoma. J Surg Oncol 2008; 97(2):125–30.

    Article  PubMed  Google Scholar 

  29. Yanagita S, Natsugoe S, Uenosono Y, et al. Sentinel node micrometastases have high proliferative potential in gastric cancer. J Surg Res 2008; 145(2):238–43.

    Article  PubMed  CAS  Google Scholar 

  30. Wong JH, Steinemann S, Tom P, et al. Volume of lymphatic metastases does not independently influence prognosis in colorectal cancer. J Clin Oncol 2002; 20(6):1506–11.

    Article  PubMed  Google Scholar 

  31. Wiese DA, Saha S, Badin J, et al. Pathologic evaluation of sentinel lymph nodes in colorectal carcinoma. Arch Pathol Lab Med 2000; 124(12):1759–63.

    PubMed  CAS  Google Scholar 

  32. Bilchik AJ, Hoon DS, Saha S, et al. Prognostic impact of micrometastases in colon cancer: interim results of a prospective multicenter trial. Ann Surg 2007; 246(4):568–75; discussion 575–7.

    Article  PubMed  Google Scholar 

  33. Liu Z, Jiang M, Zhao J, Ju H. Circulating tumor cells in perioperative esophageal cancer patients: quantitative assay system and potential clinical utility. Clin Cancer Res 2007; 13(10):2992–7.

    Article  PubMed  CAS  Google Scholar 

  34. Nakamura T, Matsunami K, Hayashi K, et al. Detection of bone marrow micrometastasis in esophageal cancer patients by immunomagnetic separation. Oncol Rep 2004; 11(5):999–1003.

    PubMed  Google Scholar 

  35. Natsugoe S, Nakashima S, Nakajo A, et al. Bone marrow micrometastasis detected by RT-PCR in esophageal squamous cell carcinoma. Oncol Rep 2003; 10(6):1879–83.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Takashi Aikou MD, PhD, Yoshikazu Uenosono MD, PhD & Shoji Natsugoe MD, PhD

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

    Yuko Kitagawa MD, PhD

  3. Department of Surgical Oncology, California Oncology Research Institute and David Geffen School of Medicine University of California, Los Angeles, CA, USA

    Anton J. Bilchik MD, PhD

  4. Department of Breast Medical Oncology, The University of Texas, M. D. Anderson Cancer Center, Houston, USA

    Naoto T. Ueno MD, PhD

Authors
  1. Takashi Aikou MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuko Kitagawa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshikazu Uenosono MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shoji Natsugoe MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anton J. Bilchik MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naoto T. Ueno MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, University of California, San Francisco, Divisadero St. 1600, San Francisco, 94115, USA

    Stanley P. L. Leong

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Aikou, T., Kitagawa, Y., Uenosono, Y., Natsugoe, S., Bilchik, A.J., Ueno, N.T. (2009). Gastrointestinal Cancer and the Lymphatic System: Patterns of Micrometastasis and Lymphatic Mapping with Clinical Outcome. In: Leong, S. (eds) From Local Invasion to Metastatic Cancer. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-087-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-087-8_4

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-086-1

  • Online ISBN: 978-1-60327-087-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation