Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7431
Peer-review started: March 29, 2016
First decision: May 12, 2016
Revised: May 22, 2016
Accepted: July 6, 2016
Article in press: July 6, 2016
Published online: September 7, 2016
Accurate prediction of lymph node (LN) status is crucially important for appropriate treatment planning in patients with early gastric cancer (EGC). However, consensus on patient and tumor characteristics associated with LN metastasis are yet to be reached. Through systematic search, we identified several independent variables associated with LN metastasis in EGC, which should be included in future research to assess which of these variables remain as significant predictors of LN metastasis. On the other hand, even if we use these promising parameters, we should realize the limitation and the difficulty of predicting LN metastasis accurately. The sentinel LN (SLN) is defined as first possible site to receive cancer cells along the route of lymphatic drainage from the primary tumor. The absence of metastasis in SLN is believed to correlate with the absence of metastasis in downstream LNs. In this review, we have attempted to focus on several independent parameters which have close relationship between tumor and LN metastasis in EGC. In addition, we evaluated the history of sentinel node navigation surgery and the usefulness for EGC.
Core tip: In this review, we have attempted to focus on several independent parameters which have close relationship between tumor and lymph node metastasis in early gastric cancer. In addition, we evaluated the usefulness of sentinel node navigation surgery (SNNS) for patients with gastric cancer, in particular technical procedure of SNNS using Infrared Ray Electronic Endoscopes combined with Indocyanine Green injection.