Fluorescent Lymphography-Guided Lymphadenectomy during Minimally Invasive Completion Total Gastrectomy for Remnant Gastric Cancer Patients

Nasser Alrashidi, Ki Yoon Kim, Sung Hyun Park, Sejin Lee, Minah Cho, Yoo Min Kim, Hyoung Il Kim, Woo Jin Hyung

Research output: Contribution to journalArticlepeer-review

Abstract

No study has evaluated fluorescent lymphography for lymphadenectomy in remnant gastric cancer (RGC). This study aimed to assess the clinical application of fluorescent lymphography in minimally invasive completion total gastrectomy for RGC. Patients who had undergone minimally invasive completion total gastrectomy for RGC from 2013 to 2020 were retrospectively reviewed. The perioperative outcomes and long-term prognosis were compared between patients who had undergone minimally invasive completion total gastrectomy with fluorescent lymphography (the FL group) and those without fluorescent lymphography (the non-FL group). The FL group comprised 32 patients, and the non-FL group comprised 36 patients. FL visualized lymphatics in all 32 patients without complications related to the fluorescent injection. The median number [the interquartile range] of LN retrieval was significantly higher in the FL group (17 [9.3–23.5]) than in the non-FL group (12.5 [4–17.8]); p = 0.016). The sensitivity of fluorescent lymphography in detecting metastatic LN stations was 75%, and the negative predictive value was 96.9% in the FL group. The overall relapse-free survivals were comparable between the groups (p = 0.833 and p = 0.524, respectively). FL is an effective tool to perform a more thorough lymphadenectomy during minimally invasive completion total gastrectomy for RGC. Using FL in RGC surgery may improve surgical quality and proper staging.

Original languageEnglish
Article number5037
JournalCancers
Volume14
Issue number20
DOIs
Publication statusPublished - 2022 Oct

Bibliographical note

Funding Information:
This study was supported by a grant from the Investigator Sponsored Research Program (ISR-2017-10924), Covidien Private Limited (Medtronic). This funding source played no role in the design of this study and will not play any role in its execution, data analyses, interpretation, or decision to submit its results for presentation or publication.

Funding Information:
W.J.H. reports receiving research grants from Medtronic and GC Pharma and is a stockholder and chief executive officer of Hutom. He provided consultancy services to Ethicon and SK Hynix (Wuxi) outside of the submitted work. The other authors have no disclosures to report.

Publisher Copyright:
© 2022 by the authors.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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