Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2016; 22(33): 7431-7439
Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7431
Prediction of lymph node metastasis and sentinel node navigation surgery for patients with early-stage gastric cancer
Atsuo Shida, Norio Mitsumori, Hiroshi Nimura, Yuta Takano, Taizou Iwasaki, Muneharu Fujisaki, Naoto Takahashi, Katsuhiko Yanaga
Atsuo Shida, Norio Mitsumori, Hiroshi Nimura, Yuta Takano, Taizou Iwasaki, Muneharu Fujisaki, Naoto Takahashi, Katsuhiko Yanaga, Department of Surgery, Jikei University School of Medicine, Tokyo 105-8461, Japan
Author contributions: Shida A wrote the paper; Mitsumori N, Nimura H, Iwasaki T, Fujisaki M, Takahashi N and Yanaga K perfomed the collected the data; all the authors contributed to this manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Atsuo Shida, MD, PhD, Department of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. atsuoshida@ybb.ne.jp
Telephone: +81-3-34331111 Fax: +81-3-54724140
Received: March 26, 2016
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
Abstract

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.

Keywords: Early-stage gastric cancer, Sentinel node navigation surgery, Prediction of lymph node metastasis

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.