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. 2017:2017:1732571.
doi: 10.1155/2017/1732571. Epub 2017 Jun 15.

Which Factors Are Important for Successful Sentinel Node Navigation Surgery in Gastric Cancer Patients? Analysis from the SENORITA Prospective Multicenter Feasibility Quality Control Trial

Ji Yeong An  1 , Jae Seok Min  2 , Young Joon Lee  3 , Sang Ho Jeong  4 , Hoon Hur  5 , Sang Uk Han  5 , Woo Jin Hyung  6 , Gyu Seok Cho  7 , Gui Ae Jeong  7 , Oh Jeong  8 , Young Kyu Park  8 , Mi Ran Jung  8 , Ji Yeon Park  9 , Young Woo Kim  10 , Hong Man Yoon  10 , Bang Wool Eom  10 , Keun Won Ryu  10
Affiliations

Which Factors Are Important for Successful Sentinel Node Navigation Surgery in Gastric Cancer Patients? Analysis from the SENORITA Prospective Multicenter Feasibility Quality Control Trial

Ji Yeong An et al. Gastroenterol Res Pract. 2017.

Abstract

Background: We investigated the results of quality control study prior to phase III trial of sentinel lymph node navigation surgery (SNNS).

Methods: Data were reviewed from 108 patients enrolled in the feasibility study of laparoscopic sentinel basin dissection (SBD) in gastric cancer. Seven steps contain tracer injection at submucosa (step 1) and at four sites (step 2) by intraoperative esophagogastroduodenoscopy (EGD), leakage of tracer (step 3), injection within 3 minutes (step 4), identification of at least one sentinel basin (SB) (step 5), evaluation of sentinel basin nodes (SBNs) by frozen biopsy (step 6), and identification of at least five SBNs at back table and frozen sections (step 7).

Results: Failure in step 7 (n = 23) was the most common followed by step 3 (n = 15) and step 6 (n = 13). We did not find any differences of clinicopathological factors between success and failure group in steps 1~6. In step 7, body mass index (BMI) was only the significant factor. The success rate was 97.1% in patients with BMI < 23 kg/m2 and 80.3% in those with BMI ≥ 23 kg/m2 (P = 0.028).

Conclusions: Lower BMI group showed higher success rate in step 7. Surgeons doing SNNS should be cautious when evaluating sufficient number of SBN in obese patients.

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Figures

Figure 1
Figure 1
Definition of sentinel basin nodes. GN: green node, HN: hot node, HGN: hot and green node, and BN: basin node.
Figure 2
Figure 2
Harvest procedure of sentinel basin nodes at back table.
Figure 3
Figure 3
Effect of patient BMI on the identification of at least 5 sentinel basin nodes (step 7 in checklist).
See this image and copyright information in PMC

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