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Erschienen in: Gastric Cancer 4/2019

01.07.2019 | Original Article

Prospective feasibility study for single-tracer sentinel node mapping by ICG (indocyanine green) fluorescence and OSNA (one-step nucleic acid amplification) assay in laparoscopic gastric cancer surgery

verfasst von: Yoshiaki Shoji, Koshi Kumagai, Satoshi Kamiya, Satoshi Ida, Souya Nunobe, Manabu Ohashi, Shoichi Yoshimizu, Yusuke Horiuchi, Toshiyuki Yoshio, Akiyoshi Ishiyama, Toshiaki Hirasawa, Tomo Osako, Noriko Yamamoto, Junko Fujisaki, Takeshi Sano, Naoki Hiki

Erschienen in: Gastric Cancer | Ausgabe 4/2019

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Abstract

Background

The double-tracer method has been established for sentinel node (SN) mapping in gastric cancer surgery. However, there remain several unresolved issues that prevent its widespread use in clinical practice. In this study, we aimed to demonstrate the feasibility of single-tracer SN mapping in laparoscopic surgery for gastric cancer, using indocyanine green (ICG) fluorescence imaging with a one-step nucleic acid amplification (OSNA) assay intraoperatively.

Methods

Patients with clinical T1N0M0 gastric adenocarcinoma preoperatively were considered for inclusion if they had a single primary lesion 4 cm or less in maximal diameter. Immunohistochemical staining with the anti-cytokeratin 19 antibody was performed on preoperative biopsy specimens, and patients with faint positive reactions were excluded. Intraoperatively, single-tracer SN biopsy with ICG fluorescence imaging was performed, followed by laparoscopic gastrectomy with modified D1+ or D2 lymph node dissection.

Results

Twenty eligible patients underwent SN biopsy and laparoscopic gastrectomy. SNs were identified in 17 cases (85%), with a median number of three SNs per patient. The median times for SN mapping and OSNA assay were 19 and 35 min, respectively. OSNA assay detected one metastatic lymph node, but all other nodes were negative. No adverse effects were observed in relation to SN mapping.

Conclusions

Single-tracer SN mapping by ICG fluorescence imaging with intraoperative diagnosis by OSNA assay is feasible and safe. SNs can be identified in most patients, without producing false-negative results. Further clinical trial to demonstrate the sensitivity is ongoing.
Literatur
1.
Zurück zum Zitat Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13(4):238–44.CrossRefPubMed Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13(4):238–44.CrossRefPubMed
2.
Zurück zum Zitat Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study G. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245(1):68–72.CrossRefPubMedPubMedCentral Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study G. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245(1):68–72.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc. 2004;18(2):182–5.CrossRefPubMed Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc. 2004;18(2):182–5.CrossRefPubMed
4.
Zurück zum Zitat Zeng YK, Yang ZL, Peng JS, Lin HS, Cai L. Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: evidence from randomized and nonrandomized clinical trials. Ann Surg. 2012;256(1):39–52.CrossRefPubMed Zeng YK, Yang ZL, Peng JS, Lin HS, Cai L. Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: evidence from randomized and nonrandomized clinical trials. Ann Surg. 2012;256(1):39–52.CrossRefPubMed
5.
Zurück zum Zitat Hiki N, Katai H, Mizusawa J, Nakamura K, Nakamori M, Yoshikawa T, et al. Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703). Gastric Cancer. 2017;21(1):155–61.CrossRefPubMed Hiki N, Katai H, Mizusawa J, Nakamura K, Nakamori M, Yoshikawa T, et al. Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703). Gastric Cancer. 2017;21(1):155–61.CrossRefPubMed
6.
Zurück zum Zitat Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2016;263(1):28–35.CrossRefPubMed Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2016;263(1):28–35.CrossRefPubMed
7.
Zurück zum Zitat Takeuchi H, Goto O, Yahagi N, Kitagawa Y. Function-preserving gastrectomy based on the sentinel node concept in early gastric cancer. Gastric Cancer. 2017;20(Suppl 1):53–9.CrossRefPubMed Takeuchi H, Goto O, Yahagi N, Kitagawa Y. Function-preserving gastrectomy based on the sentinel node concept in early gastric cancer. Gastric Cancer. 2017;20(Suppl 1):53–9.CrossRefPubMed
8.
Zurück zum Zitat Hiratsuka M, Miyashiro I, Ishikawa O, Furukawa H, Motomura K, Ohigashi H, et al. Application of sentinel node biopsy to gastric cancer surgery. Surgery. 2001;129(3):335–40.CrossRefPubMed Hiratsuka M, Miyashiro I, Ishikawa O, Furukawa H, Motomura K, Ohigashi H, et al. Application of sentinel node biopsy to gastric cancer surgery. Surgery. 2001;129(3):335–40.CrossRefPubMed
9.
Zurück zum Zitat Kitagawa Y, Fujii H, Mukai M, Kubota T, Otani Y, Kitajima M. Radio-guided sentinel node detection for gastric cancer. Br J Surg. 2002;89(5):604–8.CrossRefPubMed Kitagawa Y, Fujii H, Mukai M, Kubota T, Otani Y, Kitajima M. Radio-guided sentinel node detection for gastric cancer. Br J Surg. 2002;89(5):604–8.CrossRefPubMed
10.
Zurück zum Zitat Miwa K, Kinami S, Taniguchi K, Fushida S, Fujimura T, Nonomura A. Mapping sentinel nodes in patients with early-stage gastric carcinoma. Br J Surg. 2003;90(2):178–82.CrossRefPubMed Miwa K, Kinami S, Taniguchi K, Fushida S, Fujimura T, Nonomura A. Mapping sentinel nodes in patients with early-stage gastric carcinoma. Br J Surg. 2003;90(2):178–82.CrossRefPubMed
11.
Zurück zum Zitat Hayashi H, Ochiai T, Mori M, Karube T, Suzuki T, Gunji Y, et al. Sentinel lymph node mapping for gastric cancer using a dual procedure with dye- and gamma probe-guided techniques. J Am Coll Surg. 2003;196(1):68–74.CrossRefPubMed Hayashi H, Ochiai T, Mori M, Karube T, Suzuki T, Gunji Y, et al. Sentinel lymph node mapping for gastric cancer using a dual procedure with dye- and gamma probe-guided techniques. J Am Coll Surg. 2003;196(1):68–74.CrossRefPubMed
12.
Zurück zum Zitat Isozaki H, Kimura T, Tanaka N, Satoh K, Matsumoto S, Ninomiya M, et al. An assessment of the feasibility of sentinel lymph node-guided surgery for gastric cancer. Gastric Cancer. 2004;7(3):149–53.CrossRefPubMed Isozaki H, Kimura T, Tanaka N, Satoh K, Matsumoto S, Ninomiya M, et al. An assessment of the feasibility of sentinel lymph node-guided surgery for gastric cancer. Gastric Cancer. 2004;7(3):149–53.CrossRefPubMed
13.
Zurück zum Zitat Arigami T, Natsugoe S, Uenosono Y, Mataki Y, Ehi K, Higashi H, et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription-polymerase chain reaction. Ann Surg. 2006;243(3):341–7.CrossRefPubMedPubMedCentral Arigami T, Natsugoe S, Uenosono Y, Mataki Y, Ehi K, Higashi H, et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription-polymerase chain reaction. Ann Surg. 2006;243(3):341–7.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Kitagawa Y, Takeuchi H, Takagi Y, Natsugoe S, Terashima M, Murakami N, et al. Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol. 2013;31(29):3704–10.CrossRefPubMed Kitagawa Y, Takeuchi H, Takagi Y, Natsugoe S, Terashima M, Murakami N, et al. Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol. 2013;31(29):3704–10.CrossRefPubMed
15.
Zurück zum Zitat Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127(4):392–9.CrossRefPubMed Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127(4):392–9.CrossRefPubMed
16.
Zurück zum Zitat Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220(3):391–8 (discussion 8-401).CrossRefPubMedPubMedCentral Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220(3):391–8 (discussion 8-401).CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Miyashiro I, Hiratsuka M, Sasako M, Sano T, Mizusawa J, Nakamura K, et al. High false-negative proportion of intraoperative histological examination as a serious problem for clinical application of sentinel node biopsy for early gastric cancer: final results of the Japan Clinical Oncology Group multicenter trial JCOG0302. Gastric Cancer. 2014;17(2):316–23.CrossRefPubMed Miyashiro I, Hiratsuka M, Sasako M, Sano T, Mizusawa J, Nakamura K, et al. High false-negative proportion of intraoperative histological examination as a serious problem for clinical application of sentinel node biopsy for early gastric cancer: final results of the Japan Clinical Oncology Group multicenter trial JCOG0302. Gastric Cancer. 2014;17(2):316–23.CrossRefPubMed
18.
Zurück zum Zitat Bostick P, Essner R, Glass E, Kelley M, Sarantou T, Foshag LJ, et al. Comparison of blue dye and probe-assisted intraoperative lymphatic mapping in melanoma to identify sentinel nodes in 100 lymphatic basins. Arch Surg. 1999;134(1):43–9.CrossRefPubMed Bostick P, Essner R, Glass E, Kelley M, Sarantou T, Foshag LJ, et al. Comparison of blue dye and probe-assisted intraoperative lymphatic mapping in melanoma to identify sentinel nodes in 100 lymphatic basins. Arch Surg. 1999;134(1):43–9.CrossRefPubMed
19.
Zurück zum Zitat Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15(6):2345–50.CrossRefPubMed Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15(6):2345–50.CrossRefPubMed
20.
Zurück zum Zitat Nimura H, Narimiya N, Mitsumori N, Yamazaki Y, Yanaga K, Urashima M. Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer. Br J Surg. 2004;91(5):575–9.CrossRefPubMed Nimura H, Narimiya N, Mitsumori N, Yamazaki Y, Yanaga K, Urashima M. Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer. Br J Surg. 2004;91(5):575–9.CrossRefPubMed
21.
Zurück zum Zitat Ishikawa K, Yasuda K, Shiromizu A, Etoh T, Shiraishi N, Kitano S. Laparoscopic sentinel node navigation achieved by infrared ray electronic endoscopy system in patients with gastric cancer. Surg Endosc. 2007;21(7):1131–4.CrossRefPubMed Ishikawa K, Yasuda K, Shiromizu A, Etoh T, Shiraishi N, Kitano S. Laparoscopic sentinel node navigation achieved by infrared ray electronic endoscopy system in patients with gastric cancer. Surg Endosc. 2007;21(7):1131–4.CrossRefPubMed
22.
Zurück zum Zitat Kusano M, Tajima Y, Yamazaki K, Kato M, Watanabe M, Miwa M. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg. 2008;25(2):103–8.CrossRefPubMed Kusano M, Tajima Y, Yamazaki K, Kato M, Watanabe M, Miwa M. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg. 2008;25(2):103–8.CrossRefPubMed
23.
Zurück zum Zitat Tajima Y, Yamazaki K, Masuda Y, Kato M, Yasuda D, Aoki T, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg. 2009;249(1):58–62.CrossRefPubMed Tajima Y, Yamazaki K, Masuda Y, Kato M, Yasuda D, Aoki T, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg. 2009;249(1):58–62.CrossRefPubMed
24.
Zurück zum Zitat Tajima Y, Murakami M, Yamazaki K, Masuda Y, Kato M, Sato A, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging during laparoscopic surgery in gastric cancer. Ann Surg Oncol. 2010;17(7):1787–93.CrossRefPubMed Tajima Y, Murakami M, Yamazaki K, Masuda Y, Kato M, Sato A, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging during laparoscopic surgery in gastric cancer. Ann Surg Oncol. 2010;17(7):1787–93.CrossRefPubMed
25.
Zurück zum Zitat Miyashiro I, Kishi K, Yano M, Tanaka K, Motoori M, Ohue M, et al. Laparoscopic detection of sentinel node in gastric cancer surgery by indocyanine green fluorescence imaging. Surg Endosc. 2011;25(5):1672–6.CrossRefPubMed Miyashiro I, Kishi K, Yano M, Tanaka K, Motoori M, Ohue M, et al. Laparoscopic detection of sentinel node in gastric cancer surgery by indocyanine green fluorescence imaging. Surg Endosc. 2011;25(5):1672–6.CrossRefPubMed
26.
Zurück zum Zitat Yamamoto H, Sekimoto M, Oya M, Yamamoto N, Konishi F, Sasaki J, et al. OSNA-based novel molecular testing for lymph node metastases in colorectal cancer patients: results from a multicenter clinical performance study in Japan. Ann Surg Oncol. 2011;18(7):1891–8.CrossRefPubMed Yamamoto H, Sekimoto M, Oya M, Yamamoto N, Konishi F, Sasaki J, et al. OSNA-based novel molecular testing for lymph node metastases in colorectal cancer patients: results from a multicenter clinical performance study in Japan. Ann Surg Oncol. 2011;18(7):1891–8.CrossRefPubMed
27.
Zurück zum Zitat Tamaki Y, Akiyama F, Iwase T, Kaneko T, Tsuda H, Sato K, et al. Molecular detection of lymph node metastases in breast cancer patients: results of a multicenter trial using the one-step nucleic acid amplification assay. Clin Cancer Res. 2009;15(8):2879–84.CrossRefPubMed Tamaki Y, Akiyama F, Iwase T, Kaneko T, Tsuda H, Sato K, et al. Molecular detection of lymph node metastases in breast cancer patients: results of a multicenter trial using the one-step nucleic acid amplification assay. Clin Cancer Res. 2009;15(8):2879–84.CrossRefPubMed
28.
Zurück zum Zitat Godey F, Leveque J, Tas P, Gandon G, Poree P, Mesbah H, et al. Sentinel lymph node analysis in breast cancer: contribution of one-step nucleic acid amplification (OSNA). Breast Cancer Res Treat. 2012;131(2):509–16.CrossRefPubMed Godey F, Leveque J, Tas P, Gandon G, Poree P, Mesbah H, et al. Sentinel lymph node analysis in breast cancer: contribution of one-step nucleic acid amplification (OSNA). Breast Cancer Res Treat. 2012;131(2):509–16.CrossRefPubMed
29.
Zurück zum Zitat Kumagai K, Yamamoto N, Miyashiro I, Tomita Y, Katai H, Kushima R, et al. Multicenter study evaluating the clinical performance of the OSNA assay for the molecular detection of lymph node metastases in gastric cancer patients. Gastric Cancer. 2014;17(2):273–80.CrossRefPubMed Kumagai K, Yamamoto N, Miyashiro I, Tomita Y, Katai H, Kushima R, et al. Multicenter study evaluating the clinical performance of the OSNA assay for the molecular detection of lymph node metastases in gastric cancer patients. Gastric Cancer. 2014;17(2):273–80.CrossRefPubMed
30.
Zurück zum Zitat Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12.CrossRef Japanese Gastric Cancer A. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12.CrossRef
31.
Zurück zum Zitat Japanese Gastric Cancer A. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20(1):1–19.CrossRef Japanese Gastric Cancer A. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20(1):1–19.CrossRef
32.
Zurück zum Zitat Yaguchi Y, Sugasawa H, Tsujimoto H, Takata H, Nakabayashi K, Ichikura T, et al. One-step nucleic acid amplification (OSNA) for the application of sentinel node concept in gastric cancer. Ann Surg Oncol. 2011;18(8):2289–96.CrossRefPubMed Yaguchi Y, Sugasawa H, Tsujimoto H, Takata H, Nakabayashi K, Ichikura T, et al. One-step nucleic acid amplification (OSNA) for the application of sentinel node concept in gastric cancer. Ann Surg Oncol. 2011;18(8):2289–96.CrossRefPubMed
33.
Zurück zum Zitat Kumagai K, Hiki N, Nunobe S, Jiang X, Kubota T, Aikou S, et al. Different features of complications with Billroth-I and Roux-en-Y reconstruction after laparoscopy-assisted distal gastrectomy. J Gastrointest Surg. 2011;15(12):2145–52.CrossRefPubMed Kumagai K, Hiki N, Nunobe S, Jiang X, Kubota T, Aikou S, et al. Different features of complications with Billroth-I and Roux-en-Y reconstruction after laparoscopy-assisted distal gastrectomy. J Gastrointest Surg. 2011;15(12):2145–52.CrossRefPubMed
34.
Zurück zum Zitat Tsujiura M, Hiki N, Ohashi M, Nunobe S, Kumagai K, Ida S, et al. Excellent long-term prognosis and favorable postoperative nutritional status after laparoscopic pylorus-preserving gastrectomy. Ann Surg Oncol. 2017;24(8):2233–40.CrossRefPubMed Tsujiura M, Hiki N, Ohashi M, Nunobe S, Kumagai K, Ida S, et al. Excellent long-term prognosis and favorable postoperative nutritional status after laparoscopic pylorus-preserving gastrectomy. Ann Surg Oncol. 2017;24(8):2233–40.CrossRefPubMed
35.
Zurück zum Zitat Kumagai K, Hiki N, Nunobe S, Kamiya S, Tsujiura M, Ida S, et al. Impact of anatomical position of the pancreas on postoperative complications and drain amylase concentrations after laparoscopic distal gastrectomy for gastric cancer. Surg Endosc. 2018;32(9):3846–54.CrossRefPubMed Kumagai K, Hiki N, Nunobe S, Kamiya S, Tsujiura M, Ida S, et al. Impact of anatomical position of the pancreas on postoperative complications and drain amylase concentrations after laparoscopic distal gastrectomy for gastric cancer. Surg Endosc. 2018;32(9):3846–54.CrossRefPubMed
36.
Zurück zum Zitat Kumagai K, Hiki N, Nunobe S, Sekikawa S, Chiba T, Kiyokawa T, et al. Totally laparoscopic pylorus-preserving gastrectomy for early gastric cancer in the middle stomach: technical report and surgical outcomes. Gastric Cancer. 2015;18(1):183–7.CrossRefPubMed Kumagai K, Hiki N, Nunobe S, Sekikawa S, Chiba T, Kiyokawa T, et al. Totally laparoscopic pylorus-preserving gastrectomy for early gastric cancer in the middle stomach: technical report and surgical outcomes. Gastric Cancer. 2015;18(1):183–7.CrossRefPubMed
37.
Zurück zum Zitat Kanaya S, Kawamura Y, Kawada H, Iwasaki H, Gomi T, Satoh S, et al. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer. 2011;14(4):365–71.CrossRefPubMed Kanaya S, Kawamura Y, Kawada H, Iwasaki H, Gomi T, Satoh S, et al. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer. 2011;14(4):365–71.CrossRefPubMed
38.
Zurück zum Zitat Kitagawa Y, Fujii H, Mukai M, Kubota T, Ando N, Watanabe M, et al. The role of the sentinel lymph node in gastrointestinal cancer. Surg Clin N Am. 2000;80(6):1799–809.CrossRefPubMed Kitagawa Y, Fujii H, Mukai M, Kubota T, Ando N, Watanabe M, et al. The role of the sentinel lymph node in gastrointestinal cancer. Surg Clin N Am. 2000;80(6):1799–809.CrossRefPubMed
39.
Zurück zum Zitat Mayanagi S, Takeuchi H, Kamiya S, Niihara M, Nakamura R, Takahashi T, et al. Suitability of sentinel node mapping as an index of metastasis in early gastric cancer following endoscopic resection. Ann Surg Oncol. 2014;21(9):2987–93.CrossRefPubMed Mayanagi S, Takeuchi H, Kamiya S, Niihara M, Nakamura R, Takahashi T, et al. Suitability of sentinel node mapping as an index of metastasis in early gastric cancer following endoscopic resection. Ann Surg Oncol. 2014;21(9):2987–93.CrossRefPubMed
40.
Zurück zum Zitat Arigami T, Uenosono Y, Yanagita S, Matsushita D, Arima H, Hirata M, et al. Feasibility of sentinel node navigation surgery after noncurative endoscopic resection for early gastric cancer. J Gastroenterol Hepatol. 2013;28(8):1343–7.CrossRefPubMed Arigami T, Uenosono Y, Yanagita S, Matsushita D, Arima H, Hirata M, et al. Feasibility of sentinel node navigation surgery after noncurative endoscopic resection for early gastric cancer. J Gastroenterol Hepatol. 2013;28(8):1343–7.CrossRefPubMed
41.
Zurück zum Zitat Sekiguchi M, Oda I, Taniguchi H, Suzuki H, Morita S, Fukagawa T, et al. Risk stratification and predictive risk-scoring model for lymph node metastasis in early gastric cancer. J Gastroenterol. 2016;51(10):961–70.CrossRefPubMed Sekiguchi M, Oda I, Taniguchi H, Suzuki H, Morita S, Fukagawa T, et al. Risk stratification and predictive risk-scoring model for lymph node metastasis in early gastric cancer. J Gastroenterol. 2016;51(10):961–70.CrossRefPubMed
Metadaten
Titel
Prospective feasibility study for single-tracer sentinel node mapping by ICG (indocyanine green) fluorescence and OSNA (one-step nucleic acid amplification) assay in laparoscopic gastric cancer surgery
verfasst von
Yoshiaki Shoji
Koshi Kumagai
Satoshi Kamiya
Satoshi Ida
Souya Nunobe
Manabu Ohashi
Shoichi Yoshimizu
Yusuke Horiuchi
Toshiyuki Yoshio
Akiyoshi Ishiyama
Toshiaki Hirasawa
Tomo Osako
Noriko Yamamoto
Junko Fujisaki
Takeshi Sano
Naoki Hiki
Publikationsdatum
01.07.2019
Verlag
Springer Singapore
Erschienen in
Gastric Cancer / Ausgabe 4/2019
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-018-00919-3

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