| Budget Amount *help |
¥3,670,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥270,000)
Fiscal Year 2007: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2006: ¥2,500,000 (Direct Cost: ¥2,500,000)
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| Research Abstract |
At first, sentinel node (SN) mapping guided by indocyanine green (ICG) fluorescence imaging was conducted in 22 patients with gastric cancer and 26 patients with colorectal cancer who had undergone standard surgical resection. Immediately after the ICG injection, lymphatic vessels draining the tumor and round-shaped SNs were visualized by their bright fluorescence. Even SNs that were not green in color could be easily and clearly visualized by ICG fluorescence imaging. The SN detection rate was 90.9% in patients with gastric cancer, and 88.5% in patients with colorectal cancer. The preliminary results show that ICG fluorescence imaging allows easy, highly sensitive and real-time imaging-guided SN mapping in patients with gastric or colorectal cancer. (Dig Surg 2008 ; 25 : 103-8)
Secondly, SN mapping guided by ICG fluorescence imaging was conducted in 56 patients with gastric cancer. cT1-stage cancers were associated with a significantly higher accuracy rate (97.2% vs. 72.2%, P=0.0127) t
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han cT2-or cT3-stage cancers. A false-negative rate was 14.3% in cT1-stage cancers and 50.0% in cT2-or cT3-stage cancers, respectively. These data suggest that SN mapping guided by ICG fluorescence imaging might be useful for predicting the metastatic status in lymph nodes in cases of gastric cancer, especially those with cT1-stage cancer. (Ann Surg 2009 ; 249 : 58-62)
Finally, SN mapping guided by ICG fluorescence imaging was conducted in 77 patients with cT1-or cT2-stage gastric cancer who had undergone laparoscopy-assisted gastrectomy (LAG group ; 38 patients) or conventional open gastrectomy (OG group ; 39 patients). The detection rate and mean number of fluorescent nodes (FNs) were 94.7% and 7.9, respectively, in the LAG group, and 94.9% and 7.2, respectively, in the OG group. The accuracy and false-negative rates were 97.2% and 25%, respectively, in the LAG group, and 91.9% and 23.1%, respectively, in the OG group. Among 33 LAG group patients and 27 OG group patients without SN metastasis, lymph node metastasis was found only in non-SNs located in the same lymphatic basin as the detected SNs. These data suggest that dissection of the lymphatic basin containing SNs with laparoscopic surgery may be a promising approach as a new type of minimally invasive surgery for patients with cT1- or cT2-stage gastric cancer having no metastasis in SNs. (Ann Surg Oncol 2010 Feb 17 ; Epub ahead of print) Less
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