Abstract
In recent years, the sentinel lymph node (SLN) concept has been widely investigated in a variety of solid tumors including gastrointestinal (GI) cancer. This chapter reviews the rationale and refined technical aspects for SLN mapping in upper GI cancer for the intraoperative accurate diagnosis of nodal status to perform individualized minimally invasive surgical approaches. We have described the technical details of the procedure as we have performed it in over 350 consecutive patients with esophageal and gastric cancer and introduced pitfalls and issues remaining.
The technical details and clinical applications of SLN mapping differfor patients with esophageal cancer and gastric cancer. Radio-guided method with lymphoscintigraphy using radioisotope-labeled colloid (RI) is essential for SLN mapping for esophageal cancer. Selective lymphadenectomy and SLN-targeted chemoradiotherapy would be feasible and beneficial for the patients with esophageal cancer. For gastric cancer, combined method with dye and RI is recommended for stable and accurate sampling of SLN in the laparoscopic setting. Laparoscopic local resection for superficial gastric cancer with negative SN status would be a reasonable and less-invasive novel procedure based on the SLN concept. We can utilize this procedure not only for an accurate staging but also as a great tool to change the patient care of upper GI cancer by individualized minimally invasive treatments.
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References
Akiyama H, Tsurumaru M, Udagawa H, et al: Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg 220:364–373, 1994
Ando N, Iizuka T, Ide H et al: Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study-JCOG9204. J Clin Oncol;21:4592–4596, 2003
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 19:1128–1136, 2001
Bonenkamp JJ, Hermans J, Sasako M, et al: Extended lymph-node dissection for gastric cancer. Dutch Gastric Cancer Group. N Engl J Med 340:908–914, 1999
Hiratsuka M, Miyashiro I, Ishikawa O, et al: Application of sentinel node biopsy to gastric cancer surgery. Surgery 129:335–340, 2001
Hulsher JBF, van Sandick JW, de Boer AGEM, et al: Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 347:1662–1669, 2002
Ichikura T, Morita D, Uchida T, et al: Sentinel node concept in gastric carcinoma. World J Surg 26: 318–322, 2002
Kitagawa Y, Fujii H, Mukai M, et al: Radio-guided sentinel node detection for gastric cancer. Br J Surg 89:604–608, 2002a
Kitagawa Y, Fujii H, Mukai M, et al: Intraoperative lymphatic mapping and sentinel lymph node sampling in esophageal and gastric cancer. Surg Oncol Clin North Am 11:293–304, 2002b
Kitagawa Y, Fujii H, Mukai M, et al: The role of sentinel lymph node in gastrointestinal cancer. Surg Clin North Am 80:1799–1809, 2000
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 8(9S):86–89, 2001
Kitajima M, Kitagawa Y: Surgical treatment of esophageal cancer—The advent of the era of individualization. N Engl J Med 21:1705–1709, 2002
Kitagawa Y, Kitajima M: Diagnostic validity of radio-guided sentinel node mapping for gastric cancer. Surgical Technology International (in press), 2004
Kosaka T, Ueshima N, Sugaya J, et al: Lymphatic route of the stomach demonstrated by gastric carcinomas with solitary lymph node metastasis. Surg Today 29: 695–700, 1999
Maruyama K, Gunven P, Okabayashi K, et al: Lymph node metastases of gastric cancer. General pattern in 1931 patients. Ann Surg 210:596–602, 1989
Matsubara T, Ueda M, Kaisaki S, et al: Localization of initial lymph node metastasis from carcinoma of the thoracic esophagus. Cancer 89: 1869–1873, 2000
Miwa K, Kinami S, Taniguchi K, et al: Mapping sentinel nodes in patients with early-stage gastric carcinoma. Br J Surg 90:178–182, 2003
Sano T, Katai H, Sasako M, et al: Gastric lymphadenectomy and detection of sentinel nodes. Recent Results Cancer Res 157:253–258, 2000
Stein HJ, Sendler A, Siewert JR: Site-dependent resection techniques for gastric cancer. Surg Oncol Clin North Am 11:405–414, 2002
Vizcaino AP, Moreno V, Lambert R, et al: Time trends incidence of both major histologic types of esophageal carcinomas in selected countries, 1973–1995. Int J Cancer 99:860–868, 2002
Yasuda S, Shimada H, Chino O, et al: Sentinel lymph node detection with Tc-99m tin colloids in patients with esophagogastric cancer. Jpn J Clin Oncol 33:68–72, 2003
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Kitagawa, Y., Fujii, H., Mukai, M., Kubo, A., Kitajima, M. (2005). Sentinel Lymph Node Mapping in Esophageal and Gastric Cancer. In: Leong, S.P.L., Kitagawa, Y., Kitajima, M. (eds) Selective Sentinel Lymphadenectomy for Human Solid Cancer. Cancer Treatment and Research, vol 127. Springer, Boston, MA. https://doi.org/10.1007/0-387-23604-X_6
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DOI: https://doi.org/10.1007/0-387-23604-X_6
Publisher Name: Springer, Boston, MA
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