Research progress of assisted techniques for lymph node dissection in gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DING Tianlong ^1,2 , XU Bo ¹ , WANG Yunpeng ¹ , ZHANG Jing ¹ , WANG Haiyun ¹ , HE Puyi ¹ , ZHU Jingyu ¹ ,  CHEN Hao ^2,3

1. Lanzhou University Second School of Clinical Medicine, Lanzhou 730030, P. R. China;
2. Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730030, P. R. China;
3. Key Laboratory of Digestive System Tumors, Lanzhou University Second Hospital, Lanzhou 730030, P. R. China;

Corresponding author：

CHEN Hao, Email: ery_chenh@lzu.edu.cn

Keywords：

gastric cancer; lymph node dissection; lymphatic tracer; radical gastrectomy

DOI：

10.7507/1007-9424.202105049

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the research progress of assisted techniques for lymph node dissection in gastric cancer. Method The literatures on the applications of assisted techniques of lymph node dissection in the gastric cancer radical gastrectomy in recent years were reviewed. Results At present, the assisted techniques used for lymph node dissection in the radical gastrectomy mainly included the lymphatic tracing technology and laparoscopic and robotic surgeries. The lymphatic tracing technology mainly included the use of dye tracers, indocyanine green, gamma probe, intraoperative radiation technology, etc. Among which gamma probe and intraoperative radiation technology were expensive and not suitable for clinical application, and intraoperative radiation technology had a radiation risk, so it was rarely used currently. At present, the dye tracers and indocyanine green were mainly used in the clinical lymph node tracing, both of which could improve the detection rate and increase the number of lymph node dissection, and improve the prognosis of patients. The laparoscopic radical gastrectomy was not inferior to traditional radical gastrectomy in terms of lymph node dissection, and had been more widely used in the clinical practice due to its advantages of visualization, minimally invasive, quickly postoperative recovery, and good short-term efficacy. Compared with the conventional laparoscopic system, the robotic surgical system was more precise, dexterous, stable, and had a better feedback feeling, which was more conducive to the lymph node dissection of special location. Conclusion Use of lymphatic tracers, laparoscopy and robotics could increase lymph node detection rate and improve prognosis of patients.

Citation： DING Tianlong, XU Bo, WANG Yunpeng, ZHANG Jing, WANG Haiyun, HE Puyi, ZHU Jingyu, CHEN Hao. Research progress of assisted techniques for lymph node dissection in gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(4): 534-538. doi: 10.7507/1007-9424.202105049 Copy

1.	Cui N, Sun Q, Liu H, et al. Long non-coding RNA LINC00511 regulates the expression of microRNA-625-5p and activates signal transducers and activators of transcription 3 (STAT3) to accelerate the progression of gastric cancer. Bioengineered, 2021, 12(1): 2915-2927.
2.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3.	Sura K, Ye H, Vu CC, et al. How many lymph nodes are enough-defining the extent of lymph node dissection in stage Ⅰ–Ⅲ gastric cancer using the National Cancer Database. J Gastrointest Oncol, 2018, 9(6): 1168-1175.
4.	No authors listed. IARC monographs on the evaluation of carcinogenic risks to humans. Solar and ultraviolet radiation. IARC Monogr Eval Carcinog Risks Hum, 1992, 55: 1-316.
5.	Guo F, Mao X, Wang J, et al. Gemcitabine adsorbed onto carbon particles increases drug concentrations at the injection site and in the regional lymph nodes in an animal experiment and a clinical study. J Int Med Res, 2011, 39(6): 2217-2227.
6.	Li Z, Ao S, Bu Z, et al. Clinical study of harvesting lymph nodes with carbon nanoparticles in advanced gastric cancer: a prospective randomized trial. World J Surg Oncol, 2016, 14: 88. doi: 10.1186/s12957-016-0835-3.
7.	Wu X, Lin Q, Chen G, et al. Sentinel lymph node detection using carbon nanoparticles in patients with early breast cancer. PLoS One, 2015, 10(8): e0135714. doi: 10.1371/journal.pone.0135714.
8.	Xu XF, Gu J. The application of carbon nanoparticles in the lymph node biopsy of cN0 papillary thyroid carcinoma: a randomized controlled clinical trial. Asian J Surg, 2017, 40(5): 345-349.
9.	麦麦提·艾合麦提, 刘少壮, 陈成, 等. 术前胃镜下纳米碳标记在腹腔镜胃癌根治术中的应用价值. 腹腔镜外科杂志, 2018, 23(1): 31-35.
10.	Landsman ML, Kwant G, Mook GA, et al. Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol, 1976, 40(4): 575-583.
11.	Alander JT, Kaartinen I, Laakso A, et al. A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging, 2012, 2012: 940585. doi: 10.1155/2012/940585.
12.	Schaafsma BE, Mieog JS, Hutteman M, et al. The clinical use of indocyanine green as a near-infrared fluorescent contrast agent for image-guided oncologic surgery. J Surg Oncol, 2011, 104(3): 323-332.
13.	Schols RM, Bouvy ND, van Dam RM, et al. Advanced intraoperative imaging methods for laparoscopic anatomy navigation: an overview. Surg Endosc, 2013, 27(6): 1851-1859.
14.	Guo J, Yang H, Wang S, et al. Comparison of sentinel lymph node biopsy guided by indocyanine green, blue dye, and their combination in breast cancer patients: a prospective cohort study. World J Surg Oncol, 2017, 15(1): 196. doi: 10.1186/s12957-017-1264-7.
15.	Gilmore DM, Khullar OV, Jaklitsch MT, et al. Identification of metastatic nodal disease in a phase 1 dose-escalation trial of intraoperative sentinel lymph node mapping in non-small cell lung cancer using near-infrared imaging. J Thorac Cardiovasc Surg, 2013, 146(3): 562-570.
16.	Valente SA, Al-Hilli Z, Radford DM, et al. Near infrared fluorescent lymph node mapping with indocyanine green in breast cancer patients: a prospective trial. J Am Coll Surg, 2019, 228(4): 672-678.
17.	Yamashita S, Tokuishi K, Anami K, et al. Video-assisted thoracoscopic indocyanine green fluorescence imaging system shows sentinel lymph nodes in non-small-cell lung cancer. J Thorac Cardiovasc Surg, 2011, 141(1): 141-144.
18.	郭文斌, 高伟, 刘金涛, 等. 吲哚菁绿荧光导航技术在乳腺癌前哨淋巴结活检中的应用. 中国普通外科杂志, 2015, 24(5): 658-662.
19.	陈涵, 叶玉坤, 韩开宝, 等. 吲哚菁绿近红外光成像系统在非小细胞肺癌术中探寻前哨淋巴结的临床应用研究. 中华临床医师杂志(电子版), 2013, 7(23): 10599-10603.
20.	Kim TH, Kong SH, Park JH, et al. Assessment of the completeness of lymph node dissection using near-infrared imaging with indocyanine green in laparoscopic gastrectomy for gastric cancer. J Gastric Cancer, 2018, 18(2): 161-171.
21.	涂儒鸿, 林建贤, 郑朝辉, 等. 吲哚菁绿荧光成像在腹腔镜胃癌根治术淋巴结清扫中的应用价值. 中华消化外科杂志, 2019, 18(5): 466-471.
22.	Yano K, Nimura H, Mitsumori N, et al. The efficiency of micrometastasis by sentinel node navigation surgery using indocyanine green and infrared ray laparoscopy system for gastric cancer. Gastric Cancer, 2012, 15(3): 287-291.
23.	Chen QY, Xie JW, Zhong Q, et al. Safety and efficacy of indocyanine green tracer-guided lymph node dissection during laparoscopic radical gastrectomy in patients with gastric cancer: a randomized clinical trial. JAMA Surg, 2020, 155(4): 300-311.
24.	Kwon IG, Son T, Kim HI, et al. Fluorescent lymphography-guided lymphadenectomy during robotic radical gastrectomy for gastric cancer. JAMA Surg, 2019, 154(2): 150-158.
25.	中国研究型医院学会微创外科学专业委员会《腹腔镜外科杂志》编辑部. 吲哚菁绿标记荧光腹腔镜技术在腹腔镜胃癌根治术中的应用专家共识. 腹腔镜外科杂志, 2019, 24(5): 395-400.
26.	Huh YJ, Lee HJ, Kim TH, et al. Efficacy of assessing intraoperative bowel perfusion with near-Infrared camera in laparoscopic gastric cancer surgery. J Laparoendosc Adv Surg Tech A, 2019, 29(4): 476-483.
27.	Kusano M, Tajima Y, Yamazaki K, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg, 2008, 25(2): 103-108.
28.	Tajima Y, Yamazaki K, Masuda Y, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg, 2009, 249(1): 58-62.
29.	Kitagawa Y, Takeuchi H, Takagi Y, et al. Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol, 2013, 31(29): 3704-3710.
30.	中华医学会外科学分会胃肠外科学组. 吲哚菁绿近红外光成像在腹腔镜胃癌根治术中应用中国专家共识(2019版). 中国实用外科杂志, 2020, 40(2): 139-144.
31.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy. Surg Laparosc Endosc, 1994, 4(2): 146-148.
32.	郭欣, 边识博, 彭正, 等. 进展期胃癌根治术中脾门淋巴结清扫的手术方式选择及转移预警评价: 一项前瞻性单中心随机对照研究. 中华胃肠外科杂志, 2020, 23(2): 144-145.
33.	周宏, 夏加增, 陈义钢. 胃癌腹腔镜辅助手术与开腹手术的单中心回顾性对照研究. 实用医学杂志, 2018, 34(19): 3255-3259.
34.	Aiolfi A, Lombardo F, Matsushima K, et al. Systematic review and updated network meta-analysis of randomized controlled trials comparing open, laparoscopic-assisted, and robotic distal gastrectomy for early and locally advanced gastric cancer. Surgery, 2021, 170(3): 942-951.
35.	Lee HJ, Hyung WJ, Yang HK, et al. Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT). Ann Surg, 2019, 270(6): 983-991.
36.	张珂诚, 曹博, 卫勃, 等. 机器人与腹腔镜辅助胃癌根治术中复杂部位淋巴结清扫对比研究. 中国肿瘤临床, 2019, 46(11): 546-550.
37.	Kim YW, Reim D, Park JY, et al. Role of robot-assisted distal gastrectomy compared to laparoscopy-assisted distal gastrectomy in suprapancreatic nodal dissection for gastric cancer. Surg Endosc, 2016, 30(4): 1547-1552.
38.	Huang YQ, Liang CH, He L, et al. Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer. J Clin Oncol, 2016, 34(18): 2157-2164.
39.	Nie K, Shi L, Chen Q, et al. Rectal cancer: assessment of neoadjuvant chemoradiation outcome based on radiomics of multiparametric MRI. Clin Cancer Res, 2016, 22(21): 5256-5264.
40.	Jiang Y, Chen C, Xie J, et al. Radiomics signature of computed tomography imaging for prediction of survival and chemotherapeutic benefits in gastric cancer. EBioMedicine, 2018, 36: 171-182.

1. Cui N, Sun Q, Liu H, et al. Long non-coding RNA LINC00511 regulates the expression of microRNA-625-5p and activates signal transducers and activators of transcription 3 (STAT3) to accelerate the progression of gastric cancer. Bioengineered, 2021, 12(1): 2915-2927.
2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3. Sura K, Ye H, Vu CC, et al. How many lymph nodes are enough-defining the extent of lymph node dissection in stage Ⅰ–Ⅲ gastric cancer using the National Cancer Database. J Gastrointest Oncol, 2018, 9(6): 1168-1175.
4. No authors listed. IARC monographs on the evaluation of carcinogenic risks to humans. Solar and ultraviolet radiation. IARC Monogr Eval Carcinog Risks Hum, 1992, 55: 1-316.
5. Guo F, Mao X, Wang J, et al. Gemcitabine adsorbed onto carbon particles increases drug concentrations at the injection site and in the regional lymph nodes in an animal experiment and a clinical study. J Int Med Res, 2011, 39(6): 2217-2227.
6. Li Z, Ao S, Bu Z, et al. Clinical study of harvesting lymph nodes with carbon nanoparticles in advanced gastric cancer: a prospective randomized trial. World J Surg Oncol, 2016, 14: 88. doi: 10.1186/s12957-016-0835-3.
7. Wu X, Lin Q, Chen G, et al. Sentinel lymph node detection using carbon nanoparticles in patients with early breast cancer. PLoS One, 2015, 10(8): e0135714. doi: 10.1371/journal.pone.0135714.
8. Xu XF, Gu J. The application of carbon nanoparticles in the lymph node biopsy of cN0 papillary thyroid carcinoma: a randomized controlled clinical trial. Asian J Surg, 2017, 40(5): 345-349.
9. 麦麦提·艾合麦提, 刘少壮, 陈成, 等. 术前胃镜下纳米碳标记在腹腔镜胃癌根治术中的应用价值. 腹腔镜外科杂志, 2018, 23(1): 31-35.
10. Landsman ML, Kwant G, Mook GA, et al. Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol, 1976, 40(4): 575-583.
11. Alander JT, Kaartinen I, Laakso A, et al. A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging, 2012, 2012: 940585. doi: 10.1155/2012/940585.
12. Schaafsma BE, Mieog JS, Hutteman M, et al. The clinical use of indocyanine green as a near-infrared fluorescent contrast agent for image-guided oncologic surgery. J Surg Oncol, 2011, 104(3): 323-332.
13. Schols RM, Bouvy ND, van Dam RM, et al. Advanced intraoperative imaging methods for laparoscopic anatomy navigation: an overview. Surg Endosc, 2013, 27(6): 1851-1859.
14. Guo J, Yang H, Wang S, et al. Comparison of sentinel lymph node biopsy guided by indocyanine green, blue dye, and their combination in breast cancer patients: a prospective cohort study. World J Surg Oncol, 2017, 15(1): 196. doi: 10.1186/s12957-017-1264-7.
15. Gilmore DM, Khullar OV, Jaklitsch MT, et al. Identification of metastatic nodal disease in a phase 1 dose-escalation trial of intraoperative sentinel lymph node mapping in non-small cell lung cancer using near-infrared imaging. J Thorac Cardiovasc Surg, 2013, 146(3): 562-570.
16. Valente SA, Al-Hilli Z, Radford DM, et al. Near infrared fluorescent lymph node mapping with indocyanine green in breast cancer patients: a prospective trial. J Am Coll Surg, 2019, 228(4): 672-678.
17. Yamashita S, Tokuishi K, Anami K, et al. Video-assisted thoracoscopic indocyanine green fluorescence imaging system shows sentinel lymph nodes in non-small-cell lung cancer. J Thorac Cardiovasc Surg, 2011, 141(1): 141-144.
18. 郭文斌, 高伟, 刘金涛, 等. 吲哚菁绿荧光导航技术在乳腺癌前哨淋巴结活检中的应用. 中国普通外科杂志, 2015, 24(5): 658-662.
19. 陈涵, 叶玉坤, 韩开宝, 等. 吲哚菁绿近红外光成像系统在非小细胞肺癌术中探寻前哨淋巴结的临床应用研究. 中华临床医师杂志(电子版), 2013, 7(23): 10599-10603.
20. Kim TH, Kong SH, Park JH, et al. Assessment of the completeness of lymph node dissection using near-infrared imaging with indocyanine green in laparoscopic gastrectomy for gastric cancer. J Gastric Cancer, 2018, 18(2): 161-171.
21. 涂儒鸿, 林建贤, 郑朝辉, 等. 吲哚菁绿荧光成像在腹腔镜胃癌根治术淋巴结清扫中的应用价值. 中华消化外科杂志, 2019, 18(5): 466-471.
22. Yano K, Nimura H, Mitsumori N, et al. The efficiency of micrometastasis by sentinel node navigation surgery using indocyanine green and infrared ray laparoscopy system for gastric cancer. Gastric Cancer, 2012, 15(3): 287-291.
23. Chen QY, Xie JW, Zhong Q, et al. Safety and efficacy of indocyanine green tracer-guided lymph node dissection during laparoscopic radical gastrectomy in patients with gastric cancer: a randomized clinical trial. JAMA Surg, 2020, 155(4): 300-311.
24. Kwon IG, Son T, Kim HI, et al. Fluorescent lymphography-guided lymphadenectomy during robotic radical gastrectomy for gastric cancer. JAMA Surg, 2019, 154(2): 150-158.
25. 中国研究型医院学会微创外科学专业委员会《腹腔镜外科杂志》编辑部. 吲哚菁绿标记荧光腹腔镜技术在腹腔镜胃癌根治术中的应用专家共识. 腹腔镜外科杂志, 2019, 24(5): 395-400.
26. Huh YJ, Lee HJ, Kim TH, et al. Efficacy of assessing intraoperative bowel perfusion with near-Infrared camera in laparoscopic gastric cancer surgery. J Laparoendosc Adv Surg Tech A, 2019, 29(4): 476-483.
27. Kusano M, Tajima Y, Yamazaki K, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg, 2008, 25(2): 103-108.
28. Tajima Y, Yamazaki K, Masuda Y, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg, 2009, 249(1): 58-62.
29. Kitagawa Y, Takeuchi H, Takagi Y, et al. Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol, 2013, 31(29): 3704-3710.
30. 中华医学会外科学分会胃肠外科学组. 吲哚菁绿近红外光成像在腹腔镜胃癌根治术中应用中国专家共识(2019版). 中国实用外科杂志, 2020, 40(2): 139-144.
31. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy. Surg Laparosc Endosc, 1994, 4(2): 146-148.
32. 郭欣, 边识博, 彭正, 等. 进展期胃癌根治术中脾门淋巴结清扫的手术方式选择及转移预警评价: 一项前瞻性单中心随机对照研究. 中华胃肠外科杂志, 2020, 23(2): 144-145.
33. 周宏, 夏加增, 陈义钢. 胃癌腹腔镜辅助手术与开腹手术的单中心回顾性对照研究. 实用医学杂志, 2018, 34(19): 3255-3259.
34. Aiolfi A, Lombardo F, Matsushima K, et al. Systematic review and updated network meta-analysis of randomized controlled trials comparing open, laparoscopic-assisted, and robotic distal gastrectomy for early and locally advanced gastric cancer. Surgery, 2021, 170(3): 942-951.
35. Lee HJ, Hyung WJ, Yang HK, et al. Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT). Ann Surg, 2019, 270(6): 983-991.
36. 张珂诚, 曹博, 卫勃, 等. 机器人与腹腔镜辅助胃癌根治术中复杂部位淋巴结清扫对比研究. 中国肿瘤临床, 2019, 46(11): 546-550.
37. Kim YW, Reim D, Park JY, et al. Role of robot-assisted distal gastrectomy compared to laparoscopy-assisted distal gastrectomy in suprapancreatic nodal dissection for gastric cancer. Surg Endosc, 2016, 30(4): 1547-1552.
38. Huang YQ, Liang CH, He L, et al. Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer. J Clin Oncol, 2016, 34(18): 2157-2164.
39. Nie K, Shi L, Chen Q, et al. Rectal cancer: assessment of neoadjuvant chemoradiation outcome based on radiomics of multiparametric MRI. Clin Cancer Res, 2016, 22(21): 5256-5264.
40. Jiang Y, Chen C, Xie J, et al. Radiomics signature of computed tomography imaging for prediction of survival and chemotherapeutic benefits in gastric cancer. EBioMedicine, 2018, 36: 171-182.

Previous Article
胰十二指肠切除术后胃肠吻合口套叠1例报道
Next Article
Research progress of immunotherapy for metastatic breast cancer

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of assisted techniques for lymph node dissection in gastric cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content