Less invasive surgery for early gastric cancer based on the low probability of lymph node metastasis

Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer

“…Many previous studies [10][11][12][13][14][15][16][17]29,30,[32][33][34][39][40][41], although not all [5,18,35,42], showed tumor histology to have no correlation with node involvement. However, in the present study, based on a nationwide investigation, in both m-and sm-cancers, the incidence of lymph node metastasis was significantly higher in undifferentiated than in differentiated tumors.…”

“…The different frequencies oßf nodal involvement in mucosal versus submucosal cancer are well known. The reported frequency of lymph node metastasis in submucosal cancer varies from 9.7% to 24.3% [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][28][29][30][31][32][33][34][35][36][37][39][40][41], whereas that in mucosal cancer is low (0%-6.4%) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][31][32][33][34][35][36][37]4...…”

Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis

“…Large size of the tumor has also been noticed to be related with undifferentiation, tumor and lymph node invasion and peritoneal recurrence in the future (Saito et al, 2006;Wang et al, 2008). Gross appearance and size of the tumor has also been introduced as an indicator for deciding the extend of lymph node resection even in early stages of gastric cancer (Tsujitani et al, 1999) and leads to modification of curative and palliative interventions (Li et al, 2009). However results of these studies differ in regard of the proposed threshold of tumor size; ranging between 35 to 100mm and even up to 8cm (Kunisaki et al, 2008).…”

Pesquisa do linfonodo sentinela em câncer gástrico com o corante azul patente

“…A principal indicação para pesquisa do linfonodo sentinela em câncer gástrico parece ser em tumores precoces T1, devido às baixas probabilidades de metástases para linfonodos 5,[15][16][17][18] . No entanto, nenhuma publicação relata restrição do seu uso em tumores avançados (T2,T3), apenas deve-se ter idéia de que quanto maior o grau de invasão tumoral maiores as chances de casos com LFNsn falso negativo 12 . Os dois tumores nos quais é realizada a pesquisa do LFNsn, com resultados satisfatórios, são o melanoma e o câncer de mama [19][20][21] .…”

“…2007; 34(6): 367-373 Os três métodos para se realizar a pesquisa do linfonodo sentinela em câncer gástrico utilizam: o corante isolado, o radiotraçador isolado e a combinação de ambos 11,13 . A principal indicação para pesquisa do linfonodo sentinela em câncer gástrico parece ser em tumores precoces T1, devido às baixas probabilidades de metástases para linfonodos 5,[15][16][17][18] . No entanto, nenhuma publicação relata restrição do seu uso em tumores avançados (T2,T3), apenas deve-se ter idéia de que quanto maior o grau de invasão tumoral maiores as chances de casos com LFNsn falso negativo 12 .…”