Intra-Operative Diagnosis of Lymph Node Micrometastasis During Sentinel Node Navigation Surgery in Patients with Gastric Cancer

Author(s):  
Takaaki Arigami ◽  
Yoshikazu Uenosono ◽  
Shigehiro Yanagita ◽  
Takahiko Hagihara ◽  
Naoto Haraguchi ◽  
...  
2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4510-4510
Author(s):  
Keun Won Ryu ◽  
Young Woo Kim ◽  
Jae Seok Min ◽  
Ji Yeong An ◽  
Hong Man Yoon ◽  
...  

4510 Background: The benefits and hazards of laparoscopic sentinel node navigation surgery (LSNNS), compared with laparoscopic standard gastrectomy (LSG) with lymph node dissection in early gastric cancer (EGC), are unknown. The SENORITA trial investigated the clinical impact of LSNNS in EGC in terms of short-term surgical outcomes, long-term survival and quality of life. Methods: This study is a prospective, multicenter, randomized controlled, non-inferiority trial. Patients with preoperatively diagnosed gastric adenocarcinoma with T1N0 of 3 cm or less in diameter, regardless of histology, except absolute indication for endoscopic resection were eligible. Patients were randomized to LSG or LSNNS using dual tracers. The primary endpoint is 3-year disease-free survival (3yDFS). Planned sample size per arm is 290 patients with the non-inferiority margin of 2.737 in hazard ratio (HR) assuming that LSG achieve 97% 3yDFS, 5% of type 1 error and 80% of power. Three-year recurrence-free survival (3yRFS), overall survival (3yOS) and disease specific death rate (3yDSDR) were evaluated as secondary endpoints. Results: From March 2013 to December 2016, 580 patients were randomized (LSG arm 292 vs. LSNNS arm 288). After 53 patients dropped out before surgery, operation was performed in 527 patients (269 vs. 258), representing the full analysis set. LSG was performed in 266 according to the protocol excluding 3 open conversion. After exclusion of 13 without LSNNS due to various reasons, LSNNS was performed in 245 patients according to the protocol. After median follow up of 47.5 months, 3yDFS were 95.5% and 91.8% (HR 1.901, CI 0.911 – 3.967), respectively. The 3yRFS was 98.9% and 95.2% (p=0.019), and 3yOS was 99.2% and 97.6% (p=0.166), and 3yDSDR was 99.5% and 99.1% (p=0.591), respectively. Conclusion: LSNNS in EGC did not show non-inferiority compared with LSG in terms of 3yDFS. However, 3yOS and 3yDSDR of LSNNS were comparable to LSG by the rescue surgery of recurrence. LSNNS might be an alternative surgical option instead of LSG in selected EGC patients. Clinical trial information: NCT01804998 .


2016 ◽  
Vol 22 (33) ◽  
pp. 7431 ◽  
Author(s):  
Atsuo Shida ◽  
Norio Mitsumori ◽  
Hiroshi Nimura ◽  
Yuta Takano ◽  
Taizou Iwasaki ◽  
...  

Author(s):  
Yoshihisa Yaguchi ◽  
Hironori Tsujimoto ◽  
Shuichi Hiraki ◽  
Nozomi Ito ◽  
Shinsuke Nomura ◽  
...  

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 606-606
Author(s):  
S. Imoto ◽  
M. Kitajima ◽  
T. Aikou ◽  
Y. Kitagawa

606 Background: Sentinel node navigation surgery (SNNS) is a standard technique to identify lymph node metastases in clinically node-negative breast cancer. However, the dye and radiopharmaceuticals for lymphatic mapping commonly used in Western countries are not available in Japan. Methods: To assess the optimal lymphatic mapping and the outcome after SNNS, the Japanese society for SNNS conducted a non-randomized multi-center prospective study on SNNS in early breast cancer. Primary endpoint is to evaluate the success rates and adverse events associated with various lymphatic mapping and SNNS, and secondary endpoint is to observe the outcome of patients who underwent SNNS during 5 years. After the protocol was approved by institutional review board, SNNS had been registered between July 2004 and October 2005. Results: Fourteen hundred and sixty-eight cases had pre-registration from 65 investigators at 23 institutions. As 46 cases were withdrawn for some reasons and 11 cases were diagnosed as benign disease, 1,411 cases were finally entered in this study. Dyes used for lymphatic mapping were indigocarmine, indocyanin green, patent blue, and isosulfun blue, and radiopharmaceuticals were 99m-technetium-labelled tin colloid, human serum albumin, and phytate. In 19 cases, superparamagnetic iron oxide was used for MRI- guided SNNS. As of December 2006, 98% of clinical report forms were analyzed. Dye-guided SNNS was performed in 240 cases, radio-guided SNNS in 56 cases, and combined method in 1,016 cases. Overall success rate was 99%. SNNS alone was treated in 1,138 cases (82%) and SNNS followed by axillary lymph node dissection in 258 cases (12%). Breast-conserving surgery was undergone in 1,175 cases (85%) and total mastectomy in 217 cases (15%). Dye-induced allergic adverse events were not reported. Postoperative adverse events of bleeding, wound infection and seroma were observed in about 1 % of cases, respectively. Conclusions: Dye-guided and/or radio-guided SNNS proved reliable for lymphatic mapping in breast cancer. The prognosis of all cases will be observed until 2010. No significant financial relationships to disclose.


2011 ◽  
Vol 15 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Kentaro Yano ◽  
Hiroshi Nimura ◽  
Norio Mitsumori ◽  
Naoto Takahashi ◽  
Hideyuki Kashiwagi ◽  
...  

2016 ◽  
Vol 402 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Naoto Takahashi ◽  
Hiroshi Nimura ◽  
Tetsuji Fujita ◽  
Norio Mitsumori ◽  
Norio Shiraishi ◽  
...  

2012 ◽  
Vol 75 (4) ◽  
pp. AB157
Author(s):  
Won Young Cho ◽  
Gene Hyun Bok ◽  
Wook Hyun Um ◽  
Kwang Yeun Shim ◽  
Chang Gyun Chun ◽  
...  

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