Current status of sentinel lymph node navigation surgery in breast and gastrointestinal tract

Akira Tangoku; Junichi Seike; Kiichiro Nakano; Taeko Nagao; Junko Honda; Takahiro Yoshida; Hiromichi Yamai; Hisashi Matsuoka; Kou Uyama; Masakazu Goto; Takanori Miyoshi; Tadaoki Morimoto

doi:10.2152/jmi.54.1

Review

Current status of sentinel lymph node navigation surgery in breast and gastrointestinal tract

Akira Tangoku, Junichi Seike, Kiichiro Nakano, Taeko Nagao, Junko Honda, Takahiro Yoshida, Hiromichi Yamai, Hisashi Matsuoka, Kou Uyama, Masakazu Goto, Takanori Miyoshi, Tadaoki Morimoto

Author information

Akira Tangoku
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Junichi Seike
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Kiichiro Nakano
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Taeko Nagao
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Junko Honda
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Takahiro Yoshida
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Hiromichi Yamai
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Hisashi Matsuoka
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Kou Uyama
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Masakazu Goto
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Takanori Miyoshi
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School
Tadaoki Morimoto
Department of Adult and Gerontological Nursing, School of Health Sciences, The University of Tokushima

Keywords: Sentinel Lymph node, Lymphatic mapping, Breast cancer, Esophageal cancer, Less invasive surgery

JOURNAL FREE ACCESS

2007 Volume 54 Issue 1,2 Pages 1-18

DOI https://doi.org/10.2152/jmi.54.1

Details

Abstract

Sentinel lymph node biopsy (SLNB) has been developed as a new diagnostic and therapeutic modality in melanoma and breast cancer surgery. The purpose of the SLNB include preventing the operative morbidity and improving the pathologic stage by focusing on fewer lymph nodes using immunocytochemic and molecular technology has almost achieved in breast cancer surgery. The prognostic meaning of immunocytochemically detected micrometastases is also evaluating in the SLN and bone marrow aspirates of women with early-stage breast cancer.
SLNB using available techniques have suggested that the lymphatic drainage of the gastrointestinal tract is much more complicated than other sites, skip metastasis being rather frequent because of an aberrant lymphatic drainage outside of the basin exist.
At the moment, the available data does not justify reduced extent of lymphadenectomy, but provides strong evidence for an improvement in tumor staging on the basis of SLNB. Two large scale prospective multi-center trials concerning feasibility of gamma-probe and dye detection for gastric cancer are ongoing in Japan.
Recent studies have shown favorable results for identification of SLN in esophageal cancer. CT lymphography with endoscopic mucosal injection of iopamidol was applicable for SLN navigation of superficial esophageal cancer.
The aim of surgical treatment is complete resection of the tumor-infiltrated organ including the regional lymph nodes. Accurate detection of SLN can achieve a selection of a more sophisticated tailor made approach. The patient can make a individualized choice from a broader spectrum of therapeutic options including endoscopic, laparoscopic or laparoscopy-assisted surgery, modified radical surgery, and typical radical surgery with lymph node dissection. Ultrastaging by detecting micrometastasis at the molecular level and the choice of an adequate treatment improve the postoperative quality of life and survival. However these issues require further investigation. J. Med. Invest. 54: 1-18, February, 2007

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