scholarly journals What’s New with Endoscopic Treatments for Early Gastric Cancer in the “Post-ESD Era”?

Digestion ◽  
2021 ◽  
pp. 1-7
Author(s):  
Osamu Goto ◽  
Mitsuru Kaise ◽  
Katsuhiko Iwakiri
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Postoperative Bleeding ◽  
Great Success ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery ◽  
Pilot Studies ◽  
Delayed Bleeding ◽  
Less Invasive ◽  
Mucosal Defect

<b><i>Background:</i></b> Endoscopic treatments for gastric cancers have still been progressing even after the great success of endoscopic submucosal dissection (ESD). <b><i>Summary:</i></b> In further advancements of ESD, safe and less-invasive procedures are challenged by managing postoperative bleeding, one of the major adverse events in ESD. Covering the mucosal defect after removal of lesions appears reasonable and effective for preventing delayed bleeding from the post-ESD ulcers. Shielding with biodegradable sheets is attempted on clinical trials, which show equivocal results. Although suturing of the mucosal rims is technically challenging, pilot studies demonstrate favorable outcomes for avoiding post-ESD bleeding even in cases at high risk. In cases after noncurative resection of ESD, the selection of patients who truly require additional gastrectomy with lymph node dissection is important to provide necessary surgery. Risk stratification of lymph node metastases and surgery has been developed, which offers tailor-made management to each patient considering the risks and benefits. In surgery, function-preserving gastrectomy to minimize the resection area in both lymphadenectomy and the primary site is clinically introduced. The sentinel node navigation surgery is promising to realize the minimally invasive gastrectomy, and it should strongly fit ESD as well as laparoscopic endoscopic cooperative surgery or endoscopic full-thickness resection, although nonexposure approaches are desirable. <b><i>Key Message:</i></b> Development for less-invasive managements on gastric cancer will be continued in step with the advancement of endoscopic treatments.

Laparoscopic sentinel node navigation surgery versus laparoscopic standard gastrectomy with lymph node dissection in early gastric cancer: Final three-year survival results of multicenter randomized controlled phase III trial (SENORITA trial).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4510-4510
Author(s):  
Keun Won Ryu ◽  
Young Woo Kim ◽  
Jae Seok Min ◽  
Ji Yeong An ◽  
Hong Man Yoon ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Early Gastric Cancer ◽  
Sentinel Node ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery ◽  
Free Survival ◽  
Randomized Controlled

4510 Background: The benefits and hazards of laparoscopic sentinel node navigation surgery (LSNNS), compared with laparoscopic standard gastrectomy (LSG) with lymph node dissection in early gastric cancer (EGC), are unknown. The SENORITA trial investigated the clinical impact of LSNNS in EGC in terms of short-term surgical outcomes, long-term survival and quality of life. Methods: This study is a prospective, multicenter, randomized controlled, non-inferiority trial. Patients with preoperatively diagnosed gastric adenocarcinoma with T1N0 of 3 cm or less in diameter, regardless of histology, except absolute indication for endoscopic resection were eligible. Patients were randomized to LSG or LSNNS using dual tracers. The primary endpoint is 3-year disease-free survival (3yDFS). Planned sample size per arm is 290 patients with the non-inferiority margin of 2.737 in hazard ratio (HR) assuming that LSG achieve 97% 3yDFS, 5% of type 1 error and 80% of power. Three-year recurrence-free survival (3yRFS), overall survival (3yOS) and disease specific death rate (3yDSDR) were evaluated as secondary endpoints. Results: From March 2013 to December 2016, 580 patients were randomized (LSG arm 292 vs. LSNNS arm 288). After 53 patients dropped out before surgery, operation was performed in 527 patients (269 vs. 258), representing the full analysis set. LSG was performed in 266 according to the protocol excluding 3 open conversion. After exclusion of 13 without LSNNS due to various reasons, LSNNS was performed in 245 patients according to the protocol. After median follow up of 47.5 months, 3yDFS were 95.5% and 91.8% (HR 1.901, CI 0.911 – 3.967), respectively. The 3yRFS was 98.9% and 95.2% (p=0.019), and 3yOS was 99.2% and 97.6% (p=0.166), and 3yDSDR was 99.5% and 99.1% (p=0.591), respectively. Conclusion: LSNNS in EGC did not show non-inferiority compared with LSG in terms of 3yDFS. However, 3yOS and 3yDSDR of LSNNS were comparable to LSG by the rescue surgery of recurrence. LSNNS might be an alternative surgical option instead of LSG in selected EGC patients. Clinical trial information: NCT01804998 .

scholarly journals Prediction of lymph node metastasis and sentinel node navigation surgery for patients with early-stage gastric cancer

2016 ◽  
Vol 22 (33) ◽  
pp. 7431 ◽  
Author(s):  
Atsuo Shida ◽  
Norio Mitsumori ◽  
Hiroshi Nimura ◽  
Yuta Takano ◽  
Taizou Iwasaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Sentinel Node ◽  
Early Stage ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery ◽  
Node Metastasis

scholarly journals Long‑term outcome following sentinel node navigation surgery for cT1 gastric cancer

2019 ◽  
Author(s):  
Yoshihisa Yaguchi ◽  
Hironori Tsujimoto ◽  
Shuichi Hiraki ◽  
Nozomi Ito ◽  
Shinsuke Nomura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Sentinel Node ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Gastric cancer indocyanine green lymph node navigation surgery: systematic review

2018 ◽  
Author(s):  
Beatrice Molteni ◽  
Paola Porsio ◽  
Sarah Molfino ◽  
Marie Sophie Alfano ◽  
Sara Benedicenti ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Navigation Surgery ◽  
Diagnostic Reagent

Sentinel lymph node (LN) biopsy is a common practice to determinate if a lymphadenectomy is needed in various malignancies. Recent studies have investigated the possibilities to extend sentinel LN biopsy in gastric cancer. Indocyanine green (ICG) is a diagnostic reagent recently introduce in sentinel LN biopsy field. This review aims to determinate the feasibility to used ICG to detect sentinel LN in gastric cancer.

Multi-center prospective study on sentinel node navigation surgery in early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 606-606
Author(s):  
S. Imoto ◽  
M. Kitajima ◽  
T. Aikou ◽  
Y. Kitagawa
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adverse Events ◽  
Prospective Study ◽  
Sentinel Node ◽  
Early Breast Cancer ◽  
Lymphatic Mapping ◽  
Axillary Lymph ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery

606 Background: Sentinel node navigation surgery (SNNS) is a standard technique to identify lymph node metastases in clinically node-negative breast cancer. However, the dye and radiopharmaceuticals for lymphatic mapping commonly used in Western countries are not available in Japan. Methods: To assess the optimal lymphatic mapping and the outcome after SNNS, the Japanese society for SNNS conducted a non-randomized multi-center prospective study on SNNS in early breast cancer. Primary endpoint is to evaluate the success rates and adverse events associated with various lymphatic mapping and SNNS, and secondary endpoint is to observe the outcome of patients who underwent SNNS during 5 years. After the protocol was approved by institutional review board, SNNS had been registered between July 2004 and October 2005. Results: Fourteen hundred and sixty-eight cases had pre-registration from 65 investigators at 23 institutions. As 46 cases were withdrawn for some reasons and 11 cases were diagnosed as benign disease, 1,411 cases were finally entered in this study. Dyes used for lymphatic mapping were indigocarmine, indocyanin green, patent blue, and isosulfun blue, and radiopharmaceuticals were 99m-technetium-labelled tin colloid, human serum albumin, and phytate. In 19 cases, superparamagnetic iron oxide was used for MRI- guided SNNS. As of December 2006, 98% of clinical report forms were analyzed. Dye-guided SNNS was performed in 240 cases, radio-guided SNNS in 56 cases, and combined method in 1,016 cases. Overall success rate was 99%. SNNS alone was treated in 1,138 cases (82%) and SNNS followed by axillary lymph node dissection in 258 cases (12%). Breast-conserving surgery was undergone in 1,175 cases (85%) and total mastectomy in 217 cases (15%). Dye-induced allergic adverse events were not reported. Postoperative adverse events of bleeding, wound infection and seroma were observed in about 1 % of cases, respectively. Conclusions: Dye-guided and/or radio-guided SNNS proved reliable for lymphatic mapping in breast cancer. The prognosis of all cases will be observed until 2010. No significant financial relationships to disclose.

scholarly journals The efficiency of micrometastasis by sentinel node navigation surgery using indocyanine green and infrared ray laparoscopy system for gastric cancer

2011 ◽  
Vol 15 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Kentaro Yano ◽  
Hiroshi Nimura ◽  
Norio Mitsumori ◽  
Naoto Takahashi ◽  
Hideyuki Kashiwagi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Indocyanine Green ◽  
Sentinel Node ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery
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