Outcome of laparoscopy-assisted gastrectomy vs. open gastrectomy for gastric cancer: a retrospective comparative study.

BACKGROUND/AIMS: Laparoscopy-assisted gastrectomy is still controversial because of scant evidence of safety and feasibility. The objective of this study was to assess the feasibility of using the laparoscopy-assisted gastrectomy in treating gastric cancer and evaluate its outcome compared with conventional open gastrectomy. METHODOLOGY: Between November 2005 and November 2007, 31 patients underwent laparoscopy-assisted gastrectomy and 95 patients underwent open gastrectomy for gastric cancer. Clinicopathological characteristics, total number of lymph nodes retrieved and overall survival were retrospectively compared between the two groups. RESULTS: No significant differences were found in the total number of retrieved lymph nodes (26.3±11.6 vs. 27.6±10.4) between the two groups. The mean follow-up and overall survival time after surgery was 30.8 (range 4-47) months and 40.9 months (95% confidence interval, 38.5-43.2 months), respectively. The mean survival time in patients of the laparoscopy-assisted gastrectomy group was 42.4 months vs. 40.3 months in patients of the open surgery alone group (p=0.457). A logistic regression model revealed that node invasion (hazard ratio 1.149, p<0.001) and serosal invasion (hazard ratio 4.623, p=0.044) were associated with overall survival of gastric cancer patients. CONCLUSIONS: Laparoscopy-assisted gastrectomy with D2 lymph node dissection is a safe and feasible procedure with adequate lymphadenectomy for the treatment of gastric cancer.

Laparoscopic local resection based on sentinel node evaluation for early gastric cancer: a preliminary report.

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.

Different criteria for radioactive sentinel lymph nodes has different impact on sentinel node biopsy in breast cancer patients.

BACKGROUND AND OBJECTIVES: This study set out to determine the impact of different criteria for radioactive sentinel lymph nodes (SLNs) on sentinel lymph node biopsy (SLNB), and the optimal criteria for radioactive SLNs. METHODS: Eighty-four breast cancer patients with cT1-2N0M0 were studied prospectively. Filtered technetium 99 m sulfur colloid was injected in peritumor parenchyma. Three different definitions of SLNs were adopted in each patient: (1) the lymph node with the highest radioactivity. (2) Any lymph node with an in vivo hot spot-to-background activity ratio of at least 3:1 or an ex vivo SLN-to-non-SLN ratio of at least 10:1. (3) All radioactive hot nodes. RESULTS: With three different definitions, the success rate of sentinel node biopsy were all 96.4%, the sensitivity was 78.9%, 92.1%, 97.4% respectively; false negative rate 21.1%, 7.9%, 2.6% respectively; predicting accuracy 90.1%, 96.3%, 98.8% respectively (P < 0.05). The first, the first two, the first three, and the first four highest radioactive sentinel nodes identified 81.1%, 89.2%, 94.6%, 100% of the positive-SLN patients, respectively. CONCLUSIONS: The different criteria for radioactive SLNs had different impact on the accuracy, sensitivity, and false negative rate, but not on the success rate, during sentinel node biopsy using radioactive sulfur colloid in breast cancer patients. The first four highest radioactive sentinel nodes could accurately predict the status of axillary metastases. J. Surg. Oncol. 2007;95:635-639. (c) 2007 Wiley-Liss, Inc.

Minute gastric carcinoid tumor with regional lymph node metastasis: a case report and review of literature.

We have encountered an unusual case of gastric carcinoid tumor. Gastroscopic examination of this 32-year-old male patient showed a smooth protrusion at the greater curvature of the gastric body with a central depression, identified by subsequent biopsy as carcinoma. The patient had a normal serum gastrin level and was negative for anti-parietal cell antibody. Histological examination of the resected gastric tissues showed that the tumor was a carcinoid, 0.3 cm x 0.3 cm in size with only one regional lymph node metastasis. We reviewed the pathogenesis, clinical presentation, diagnosis and treatment of gastric carcinoids and raise the possibility of being a lymph vessel-related metastasis even for a minute carcinoid tumor. Sentinel lymph node biopsy is recommended for surgery of minute carcinoid tumors.

[Effects of sodium hyaluronate on growth and adhesion of two human colorectal cancer cell lines in vitro].

OBJECTIVE: To investigate the effects of sodium hyaluronate on the growth and adhesion of colorectal cancer cells. METHODS: Human colorectal cancer cell lines SW620 and Colo205 were treated with sodium hyaluronate (25 -2,500 microg/ml), and cancer cell proliferation was measured by MTT assay in vitro. Flow-cytometric analysis was applied to detect expression of CD44 on SW620 and Colo205 cells. RESULT: In vitro sodium hyaluronate enhanced proliferation of Colo205 cells, but it had no appreciable effect on SW620 growth under the same doses, Meantime, CD44 expression on cancer cells decreased compared with controls. CONCLUSION: In vitro sodium hyaluronate has different effects on growth of different colorectal cancer cell lines, but can inhibit CD44 expression of colorectal cancer cells and influence their ability of adhesion.