Secondary sentinel lymph node tracing technique: a new method for tracing lymph nodes in radical gastrectomy for advanced gastric cancer

作     者：Zong-lin LI Huai-wu JIANG Min SONG Liang XU Dong XIA Qing LIU 

作者机构：Department of Gastrointestinal Surgery the First Affiliated Hospital of Sichuan Medical University Department of Gastrointestinal Surgery the Second Affiliated Hospital of North Sichuan Medical College Department of Laboratory Medicine the First Affiliated Hospital of Sichuan Medical University 

出 版 物：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 (浙江大学学报（英文版）B辑（生物医学与生物技术）)

年 卷 期：2015年第16卷第11期

页      面：897-903页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the Projects of Sichuan Provincial Health Department Scientific Research(Nos.050182 and 090250) China 

主　　题：Secondary sentinel lymph node (SSLN) Advanced gastric cancer (AGC) Individual lymphadenectomy Survival analysis 

摘      要：Objective： To explore the feasibility and clinical value of secondary sentinel lymph node （SSLN） tracing technique in radical gastrectomy for advanced gastric cancer （AGC）. Methods： From January 2009 to June 2011,247 patients who suffered from gastric angle cancer with metastasis in No. 3 group lymph nodes were divided randomly into groups A and B. Methylthioninium chloride was injected into the peripheral tissue of the metastatic No. 3 group lymph nodes of 138 patients in group A before tumor resections. SSLNs were traced and individual lymphadenectomies were carried out based on the biopsy results of the SSLNs. Standard D2 radical gastrectomies were carried out directly on 109 patients in group B. Postoperative follow-up and survival analysis were carried out for patients in both groups. Results： SSLNs were found in 114 （82.6%） patients in group A. Ninety of those patients （78.9%） demonstrated existing metastasis in SSLNs. According to Kaplan-Meier＇s method, the postoperative 3-year cumulative survival rates were 63.5% and 47.5%, and the median survival time were 40 and 36 months for the patients of groups A and B, respectively （P〈0.05）. Conclusions： The SSLN tracing technique is feasible in radical gastrectomy for AGC. It gives surgeons important information about the terminal status of lymph node metastasis and provides some scientific basis for individual lymphadenectomy.