The accuracy of sentinel node mapping according to T stage in patients with gastric cancer

Rabin, Igor; Chikman, Bar; Lavy, Ron; Poluksht, Natan; Halpern, Z; Wassermann, Ilan; Gold-Deutch, Ruth; Sandbank, Judith; Halevy, Ariel

doi:10.1007/s10120-009-0532-9

Cited by 32 publications

(28 citation statements)

References 22 publications

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“…However, out of more than 400 patients with GC operated on at our medical center, two-thirds presented with an advanced stage of the disease (Stage III-IV). This advanced stage is a common finding in the Western hemisphere, as compared to earlier stages of the disease in the East (where they have national cancer screening programs), and is the basis for the poor overall survival figures [21] observed in Israel. The overall survival figures of GC patients in Israel (as part of the Western hemisphere countries) are grim when compared to the results in the East [22,23], although a very slight increase can be noticed in the overall survival figures over the years.…”

Section: Discussionmentioning

confidence: 97%

Incidence trends and mortality rates of gastric cancer in Israel

et al. 2012

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Background Gastric cancer is the fourth most common malignancy worldwide. The incidence trends and mortality rates of gastric cancer in Israel have not been studied in depth. The aim of our study was to try and investigate the aforementioned issues in Israel in different ethnic groups. Methods This retrospective study is based on the data of The Israel National Cancer Registry and The Central Bureau of Statistics. Published data from these two institutes were collected, summarized, and analyzed in this study. Results Around 650 new cases of gastric cancer are diagnosed yearly in Israel. While we noticed a decline during the period 1990-2007 in the incidence in the Jewish population (13.6-8.9 and 6.75-5.42 cases per 100,000 in Jewish men and women, respectively), an increase in the Arab population was noticed (7.7-10.2 and 3.7-4.2 cases per 100,000 in men and women, respectively). Ageadjusted mortality rates per 10,000 cases of gastric cancer decreased significantly, from 7.21 in 1990 to 5.46 in 2007, in the total population. The 5-year relative survival showed a slight increase for both men and women. Conclusion There is a difference in the incidence and outcome of gastric cancer between the Jewish and Arab populations in Israel. The grim prognosis of gastric cancer patients in Israel is probably due to the advanced stage at which gastric cancer is diagnosed in Israel.

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Section: Discussionmentioning

confidence: 97%

Incidence trends and mortality rates of gastric cancer in Israel

et al. 2012

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“…Regarding the method chosen in this study, we used combined methods for SLNB 5,9,18,20,21 , through injection of RC and staining in the subserosa of the gastric wall 13,23,26 .…”

Section: Discussionmentioning

confidence: 99%

“…In this experiment the identification and classification of the blue and/or radioactive lymph node occurred just before and/or during exeresis of the organs, although this procedure is recommended before the gastrectomy, at varied times, according to the characteristics of the dye used 5,10,12,[15][16][17][21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the ideal time for evaluation in this model, based on the characteristics of the dye 5,9,11,14,22,23 , anatomy 35 and dimensions of the lymphatic drainage system of the animal's stomach 36 , should probably be ten minutes after the injection of AzP.…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, SLNB has also been carried out for cases of early gastric cancer 5,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

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Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Alves¹,

Lopes

Meirelles³

et al. 2012

Acta Cir. Bras.

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PURPOSE:Create and validate a proposed animal model for training in sentinel lymph node biopsy of the stomach. METHODS: In thirty-two rabbits, through a laparotomy, they received a subserosal injection of 0.1 ml of phytate labeled with technetium-99m (0.2 mCi) in the anterior wall of the gastric corpus, followed by 0.2 ml of Blue Patent V ® 2.5%, through the same puncture site. Suspicious lymph nodes were searched in vivo at five, ten and 20 minutes, both visually (Blue Patent stained lymph nodes) and with a manual gamma radiation detector (to detect suspected radioactive lymph nodes). After 20 minutes, was performed resection of these for further evaluation of radioactivity (ex vivo) and histological study. RESULTS: Lymph nodes were identified in 30 rabbits (Average of 2.2 lymph nodes per animal). Of the 90 suspected lymph nodes that occurred in the study, 70 cases (77.8%) were histologically confirmed for lymphoid tissue. Of these, the majority were located in the periesophageal region of the gastric fundus. The sample presented a mortality rate of 6.25% and nine complications related to the method, which interfered in the identification of the lymph nodes. CONCLUSION: The animal model for sentinel node biopsy in rabbit stomachs proved to be feasible, with low complexity and reproduced the difficulties encountered for gastric lymph node biopsy in humans, being adequate for surgical training. Key words: Models, Animal. Sentinel Lymph Node Biopsy. Stomach. Coloring Agents. Technetium. Rabbits. RESUMO OBJETIVO:Criar e validar uma proposta de modelo animal para o treinamento em pesquisa de linfonodos sentinelas no estômago. MÉTODOS: Em trinta e dois coelhos, mediante laparotomia, foi injetado na subserosa da parede anterior do corpo gástrico, 0,1 ml de fitato marcado com tecnécio-99m (0,2 mCi), seguido pelo mesmo orifício, de 0,2 ml de Azul Patente V ® 2,5%. A cavidade abdominal foi avaliada, in vivo, por meio de inspeção para pesquisa de suspeitas de linfonodos azuis e com detector manual de radiação gamma aos cinco, dez e 20 minutos para pesquisa de suspeitas de linfonodos radioativas. Após 20 minutos, foi realizada a ressecção dessas para posterior avaliação da radioactividade (ex vivo) e estudo histológico. RESULTADOS: Foram identificados linfonodos em 30 coelhos (Média de 2,2 linfonodos por animal). Das 90 suspeitas de linfonodos ocorridas no estudo, em 70 casos (77,8%) obteve-se confirmação histológica para tecido linfóide. Destas, a maioria estava localizada na região periesofágica do fundo gástrico. A amostra apresentou taxa de mortalidade de 6,25% e nove intercorrências relacionadas ao método, que interferiram na identificação dos linfonodos. CONCLUSÃO: O modelo animal para pesquisa de linfonodos sentinelas em estômago de coelhos mostrou-se factível, pouco complexo e reproduziu as dificuldades encontradas para a pesquisa de linfonodos gástricos em humanos, sendo adequado para o treinamento cirúrgico. Descritores: Modelos Animais. Biópsia de Linfonodo Sentinela. Estômago. Corantes. Tecnécio. Coelh...

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Diagnostic value of near‐infrared or fluorescent indocyanine green guided sentinel lymph node mapping in gastric cancer: A systematic review and meta‐analysis

Jiang

Wang

et al. 2018

Journal of Surgical Oncology

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Background This meta‐analysis was conducted to evaluate the diagnostic value of near‐infrared (NIR) or fluorescent indocyanine green (ICG) guided sentinel lymph node (SLN) mapping in gastric cancer (GC). Methods This meta‐analysis was registered at the PROSPERO. Clinical studies were retrieved from the electronic database Pubmed, Embase, Medline, Web of science, and the Cochrane Library. Quality assessment was conducted by an adapted checklist of QUADAS‐2. A bivariate mixed‐effects model was used to pool the data. Evaluation of articles quality, analysis for publication bias, summary receiver operator characteristic (SROC) curves, and meta‐regression were also performed. Subgroup analysis was used to explain the heterogeneities. Results A total of 13 clinical studies (971 patients) were included. The NIR or fluorescent imaging (FI) involved infrared ray electronic endoscopy (IREE), infrared ray laparoscopic system (IRLS), and FI system. Significant evidence of heterogeneity was found for sensitivity and specificity (I 2 = 91.1% and I 2 = 98.2%), respectively. The pooled SLN sensitivity (Sen), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 0.94(95%CI: 0.80‐0.99), 1.00(95%CI: 0.60‐1.00), 34.0(95%CI: 9.25‐125.29), 0.06(95%CI:0.02‐0.22), and 252.50(95%CI: 94.93‐671.61), respectively. Area under curve (AUC) of SROC curve was 1.00 (95%CI: 0.99‐1.00), and the summary operating point (cut‐off value) was SENS = 0.94(95%CI: 0.80‐0.99) and SPEC = 1.00(95%CI: 0.60‐1.00). Subgroup analysis showed that NIR imaging, imaging performed 20 minutes after intraoperative injection, preoperative injection (especially for FI imaging), stained with immunohistochemistry (IHC) (+hematoxylin‐eosin [HE]), cT1 stage, submucosa injection (especially for cT1), mean number of SLN ≥ 5, study size > 26 were associated with higher SLN sensitivity. In terms of ICG concentration, diluted ICG concentration that 0.5 mg/mL (compared with 5 mg/mL) in NIR imaging and 0.05 mg/mL (compared with 0.5 mg/mL) in FI system showed higher sensitivities. However, the differences in tumor diameter (≤30 mm vs >30 mm), gastrectomy methods (opening vs laparoscopy), lymphadenectomy methods (LBD vs pick‐up), and publication year (≥2010 vs <2010) did not achieve statistical significance. Conclusion ICG combined with NIR or FI guided SLN mapping is technically feasible for GC. Based on the small sample size evidence, the IREE and IRLS devices may have higher sensitivity than FI in current clinical studies; and there may be an excessive ICG concentration used for current SLN mapping in GC. However, well‐designed further studies with large sample size are needed to confirm the best procedure and suitable criteria. Mini‐abstract This meta‐analysis was registered at PROSPERO. Clinical studies on this topic were retrieved from the electronic database Pubmed, Embase, Medline, Web of Science, and the Cochrane Library. The NIR or FI involved IREE, IRLS, and FI techniques. A total of 13 clinical studies (9...

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The accuracy of sentinel node mapping according to T stage in patients with gastric cancer

Cited by 32 publications

References 22 publications

Incidence trends and mortality rates of gastric cancer in Israel

Incidence trends and mortality rates of gastric cancer in Israel

Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

Diagnostic value of near‐infrared or fluorescent indocyanine green guided sentinel lymph node mapping in gastric cancer: A systematic review and meta‐analysis

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