Lymphatic mapping and sentinel node biopsy in gastric cancer

Am J Surg. 2004 Feb;187(2):270-3. doi: 10.1016/j.amjsurg.2003.11.013.


Background: To determine the feasibility and significance of lymphatic mapping and sentinel lymph node biopsy (SLNB) in patients with gastric cancer.

Methods: From August 1999 to January 2002, 27 gastric cancer patients underwent lymphatic mapping and sentinel lymph node biopsy using isosulfan blue dye.

Results: The success rate of SLNB was 96.3% (26 of 27). Accuracy, sensitivity, and specificity were 100%. There were no false negatives. In 26 successful cases, 8 patients had positive sentinel lymph nodes and 18 had negative sentinel nodes. Of 8 patients with positive sentinel nodes, 6 had positive sentinel nodes only at N1 lymph node station, 1 only at N2 station, and 1 had positive sentinel nodes at both N1 and N2 stations. Of 18 patients with negative sentinel lymph nodes, 9 patients had sentinel nodes only at N1, 3 only at N2, 5 at both N1 and N2, and 1 at both N1 and N3. There were no cases in which sentinel lymph nodes were the only sites of metastases.

Conclusions: Sentinel lymph node biopsy using isosulfan blue dye in gastric cancer is a feasible procedure with high sensitivity and accuracy. Sentinel lymph nodes demonstrate the varied lymphatic drainage. If the sentinel nodes at N2 are positive, it will guide surgeons to do a more extended lymph node dissection in early stage gastric cancer.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Humans
  • Lymphatic Metastasis / diagnosis*
  • Male
  • Middle Aged
  • Rosaniline Dyes
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy / methods*
  • Stomach Neoplasms / pathology*


  • Rosaniline Dyes
  • iso-sulfan blue