Еxploring the possibility and accuracy of sentinel lymph node detection in gastric cancer surgical treatment

Summary. Aims: To explore the possibility and accuracy of sentinel lymph node (SLN) detection in gastric cancer surgical treatment. Materials and Methods: 157 patients with T2-4N0-2M0 gastric cancer underwent radical surgical treatment, including radical gastrectomy and D2 lymphadenectomy. SLN biopsy was performed using the intraoperative blue dye method. We investigated technical aspects of the blue dye technique and determined the accuracy, sensitivity, specificity of the SLN technique. Results: SLNs were detected in 116 of 157 patients; the total number of excised SLNs was 225, with a median of two (range 1–3). Fifty five patients had metastatic SLN. 205 of 225 detected SLNs (91%) located at the first level, and only 20 SLNs (9%) at the second level. Only ten cases SLNs were false-negative. From forty one patients with not detected SLNs, 31 (75.6%) had metastatic regional lymph nodes, and 10 (24.4%) had pN0 status. The ability of SLN biopsy to predict the status of the other lymph nodes was by a sensitivity of 91%, a specificity of 100%. Conclusions: оur study demonstrates that pick-up SLN biopsy in gastric cancer is technically feasible and has very high sensitivity.