Survival outcomes after sentinel node navigation surgery for early gastric cancer

Abstract

Aim This study evaluated the prognosis after sentinel node navigation surgery (SNNS) for early gastric cancer. Methods For 100 patients who underwent SNNS (between August 13, 2003 and December 17, 2018) at our hospital, the survival outcomes were investigated. Results (a) SN were detected with a diagnostic accuracy of 0.98. (b) Of seven patients who had positive SN metastasis, three underwent standard gastrectomy with D2 lymph node dissection. Among them, one patient died of recurrence (bone) and the other two patients were alive 4.5 and 14.7 years after surgery. The remaining four patients with positive SN who underwent diminished gastrectomy with lymphatic basin dissection at their request are alive 2.8, 6.0, 6.9 and 10.8 years after surgery without recurrence. (c) No patients who underwent diminished gastrectomy died of gastric cancer after surgery. (d) In the period following diminished gastrectomy, one patient underwent total gastrectomy and five patients underwent endoscopic submucosal dissection, and they survived for longer than 5 years. (e) As a result of SNNS, the gastric cancer‐specific cumulative 5‐year survival rate was 98.5%. Conclusions Diminished gastrectomy during SNNS resulted in a satisfactory prognosis. However, regular follow‐up after surgery is needed to detect secondary cancer of the remaining stomach.

Function-Preserving Gastrectomy for Early Gastric Cancer

“…Although there are only a few retrospective studies with small sample sizes, the prognosis of patients treated with SNNS has been reported to be good, with a 5-year overall survival rate of 98.0–98.5% [ 69 , 70 , 71 ]. SNNS may be oncologically safe in EGC, but we need to wait for the results of ongoing Japanese and Korean trials.…”

Modern surgical therapy for gastric cancer–Robotics and beyond

“…The 3‐year overall and relapse‐free survival for laparoscopic sentinel node navigation surgery is similar to those of standard gastrectomy in early gastric cancer patients 30 . Several studies have shown a comparable 5‐year survival, as well as better quality of life 31‐33 . On the basis of these results, a prospective multicenter trial to assess the survival outcomes and patients' quality of life is underway.…”

“…30 Several studies have shown a comparable 5-year survival, as well as better quality of life. [31][32][33] On the basis of these results, a prospective multicenter trial to assess the survival outcomes and patients' quality of life is underway. Additionally, a multicenter prospective trial to evaluate the feasibility of sentinel node navigation surgery after endoscopic submucosal dissection (SENORITA 2 trial) is ongoing and expected to contribute to the evolution of surgical practice in patients with early gastric cancer.…”

Essential updates 2019/2020: Perioperative and surgical management of gastric cancer

“…However, they concluded that SNNS could be an alternative if rescue surgery is appropriately performed; this was supported by 3‐year overall survival (OS) and disease‐specific survival that were equivalent to those of conventional surgery. In Japan, a single‐center study demonstrated a satisfactory 5‐year survival rate of 98.5%, in addition to a better quality of life as measured by a validated quality of life scale called the PGSAS‐45 17,18 . Currently, a multicenter triple‐arm confirmatory study that has been approved by the Japanese authority is under investigation and the result is expected to be available in several years 19 …”