N. Y. Jalaly MD; N. Valizadeh MD; S. Azizi MD; F. Kamani MD; M. Hassanzadeh MD.
UPPER GI SURGERY
Sentinel lymph node mapping and biopsy using radioactive tracer in gastric cancer
Article first published online: 18 SEP 2012
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 84, Issue 6, pages 454–458, June 2014
How to Cite
Jalaly, N. Y., Valizadeh, N., Azizi, S., Kamani, F. and Hassanzadeh, M. (2014), Sentinel lymph node mapping and biopsy using radioactive tracer in gastric cancer. ANZ Journal of Surgery, 84: 454–458. doi: 10.1111/j.1445-2197.2012.06275.x
- Issue published online: 3 JUN 2014
- Article first published online: 18 SEP 2012
- Manuscript Accepted: 15 AUG 2012
- gastric cancer;
- lymphatic mapping;
- radioactive tracer;
- sentinel lymph node
Lymph node metastasis is one of the most important prognostic factors in gastric cancer survival. Sentinel lymph node (SLN) mapping and biopsy may reduce the extension of lymph node dissection by determination of lymph node involvement. The current study prospectively evaluates the feasibility and reliability of SLN biopsy in gastric cancer.
A total of 30 patients with gastric cancer with a preoperative imaging stage of T1-T2 or T3, N0 and M0 were enrolled in the study. Furthermore, 2–16 h prior to each operation, 99mTc-sulphur colloid solution (0.5 mL, 2 mCi/mL) was endoscopically injected into the submucosal layer around the primary lesion. Lymph nodes were examined using a hand-held gamma probe. Subsequently, a total or subtotal gastrectomy and D2 lymphadenectomy was performed in each patient.
The success rate of SLN biopsy was 100%. Sensitivity, specificity, positive predictive value and negative predictive value were 91.7%, 100%, 100% and 75%, respectively. Both of the two false-negative cases were in the T3 group. In cases of T2 tumours, the sensitivity was 100%.
SLN biopsy using a gamma probe in early stage gastric cancer seems to be a safe, feasible and accurate procedure with high sensitivity in predicting regional lymph node involvement.