BACKGROUND: The objective was to determine the feasibility of using vital blue dye to map sentinel lymph nodes (SLN) in gastric cancer using a minimally invasive technique. METHODS: Sentinel lymph node biopsy was performed on 12 patients with gastric adenocarcinoma that did not have metastatic lymph nodes during clinical staging. Vital blue dye was injected around four quadrants of the tumor, 0.5 ml in each quadrant. The lymph nodes that stained blue 5 minutes after dye injection were classified as SLN. Histopathological analysis of the sentinel lymph nodes was done according to routine evaluation of other lymph nodes, with hematoxylin and eosin (HE) staining. If the SLN was negative for malignancy by means of HE, it was further examined by immunohistochemistry. RESULTS: Sentinel lymph node biopsies in gastric cancer patients were performed from July 2002 to December 2004. Twelve patients were enrolled at the study, being 8 women, with a mean age of 64.5 years (range, 48 to 87). A mean of 3.25 SLNs (range, 2 to 6) were identified in each patient. The feasibility of the procedure was 100%, and its accuracy was 91.6%. In 11 of 12 patients, it was possible to predict the regional lymph nodes status by concordance of the histopathological analysis of SLN and non-sentinel lymph nodes (nSLN). CONCLUSION: The sentinel lymph node biopsy in gastric cancer technique has demonstrated to be feasible, with the use of vital blue dye. The procedure is promising as a minimally invasive technique of gastric tumors staging, in our series.
Stomach neoplasms; Lymphatic metastasis; Neoplasm staging; Sentinel lymph node biopsy; Surgery, computer-assisted
