A multicenter non-randomized phase III study of sentinel node navigation surgery for early gastric cancer

Author:

Kamiya Satoshi1ORCID,Takeuchi Hiroya2,Fukuda Kazumasa1,Kawakubo Hirofumi1,Takahashi Naoto3,Mitsumori Norio4,Terashima Masanori5,Tsujimoto Hironori6ORCID,Kinami Shinichi7,Natsugoe Shoji8,Ohi Masaki9,Kadoya Shinichi10,Fushida Sachio11,Hayashi Hideki12,Nabeshima Kazuhito13,Sakamoto Junichi14,Matsuda Satoru1,Mayanagi Shuhei1,Irino Tomoyuki1,Sato Yasunori15,Kitagawa Yuko1

Affiliation:

1. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

2. Second Department of Surgery, Hamamatsu Medical University School of Medicine, Shizuoka, Japan

3. Department of Gastrointestinal Surgery, The Jikei University Kashiwa Hospital, Tokyo, Japan

4. Department of Surgery, The Jikei University Hospital, Tokyo, Japan

5. Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan

6. Department of Surgery, National Defense Medical College Hospital, Saitama, Japan

7. Department of Surgical Oncology, Kanazawa Medical University, Ishikawa, Japan

8. Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

9. Department of Gastroenterological Surgery, Mie University Hospital, Mie, Japan

10. Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Ishikawa, Japan

11. Department of Gastroenterological Surgery, Kanazawa University Hospital, Ishikawa, Japan

12. Department of Esophageal-Gastro-Intestinal Surgery, Chiba University Hospital, Chiba, Japan

13. Department of Gastroenterological Surgery, Tokai University Hospital, Kanagawa, Japan

14. Department of Surgery, Tokai Central Hospital, Gifu, Japan

15. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan

Abstract

Abstract This prospective multicenter non-randomized phase III study aims to evaluate the long-term outcome of sentinel node navigation surgery for early gastric cancer compared with conventional distal or total gastrectomy. Clinically diagnosed primary T1N0M0 gastric cancer patients with a single lesion (≤40 mm) and without previous endoscopic treatment will be enrolled in this study. Sentinel nodes are identified by dye and radioisotope tracers and are subjected to intraoperative rapid pathology. For patients with negative sentinel node metastasis, individualized surgery consisting of limited stomach resection and sentinel node basin dissection is performed, while standard gastrectomy with D2 lymph node dissection is employed for the positive sentinel node patients. A total of 225 patients will be accrued from 13 hospitals that have experience in sentinel node mapping. The primary endpoint is 5-year relapse-free survival. The secondary endpoints are overall survival, sentinel node detection rate, diagnostic accuracy for sentinel node, distribution of sentinel nodes and metastatic sentinel node/non-sentinel node, and postoperative quality of life.

Funder

Keio University School of Medicine Cancer Research Endowed course

Japan Agency for Medical Research and Development

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology,General Medicine

Reference26 articles.

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