Mode
Text Size
Log in / Sign up

Frozen section accuracy in sentinel lymph node biopsy for early gastric cancer patientsNew Test Helps Surgeons Check for Stomach Cancer Spread During Surgery

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider standard surgical approach if frozen section confirmation is absent in early gastric cancer sentinel lymph node biopsy.

This retrospective analysis examined 238 patients with early gastric cancer treated by sentinel lymph node biopsy followed by lymph node dissection at a tertiary hospital. The intervention involved intraoperative pathological examination of sentinel lymph nodes using either frozen section or permanent pathological examination (FFPE sections), with FFPE sections serving as the comparator.

Regarding primary outcomes, lymph node metastasis upon permanent pathological examination was identified in 30 of 238 patients. Macrometastasis was confirmed in both frozen and FFPE sections in 13 patients. In instances where tumor-positive lymph nodes were identified in frozen sections, metastasis was detected in non-sentinel lymph nodes in 2 of 24 cases, representing 8.3%.

No lymph node recurrence was observed in patients with negative sentinel lymph nodes in frozen sections but micrometastasis in FFPE sections. Safety data, adverse events, and discontinuations were not reported in the study. The study did not report p-values or confidence intervals for the primary outcomes.

Key limitations include the retrospective design and the lack of reported follow-up duration. The practice relevance suggests that the single-section hematoxylin and eosin staining method is efficacious for detecting macrometastatic tumors. If frozen section results are definitively negative, sentinel basin dissection may proceed safely; otherwise, the standard surgical approach is advisable.

Why timing is everything

Currently, doctors often remove many lymph nodes just to be safe. This can cause more pain and longer recovery times. But removing too many healthy nodes can hurt your body.

They need a way to know for sure during the operation. Old methods relied on waiting days for lab results. Surgeons had to guess based on what they saw.

The surprising shift

Old methods relied on waiting days for lab results. Surgeons had to guess based on what they saw. This meant some patients got too much surgery. Others might have missed hidden cancer cells.

Now, a new technique offers answers in minutes. It changes how doctors plan the final steps of the cut. This shift could save patients from unnecessary pain.

Think of this test like a security scanner at an airport. It checks bags quickly to find dangerous items. Here, the scanner looks at lymph nodes in real time.

The team used a method called frozen section analysis. They freeze the tissue and cut it very thin. Then they look at it under a microscope immediately.

Researchers looked at data from 238 patients at one hospital. These patients had early stomach cancer and lymph node surgery. The team tracked how often the test worked correctly.

They also checked if cancer was hiding in other nodes. The study focused on early stages of the disease. This ensures the results apply to similar cases.

The test worked very well for finding big clusters of cancer. In most cases, it matched the final lab results perfectly. However, small clusters of cells were sometimes missed.

These small clusters did not come back during follow-up. When the test said cancer was present, it was right most of the time. But if the test said no cancer, there was still a small risk.

This doesn’t mean this treatment is available yet.

About 8 out of 100 patients had hidden cancer elsewhere. This helps doctors decide if they need to cut more. It balances safety with quality of life for the patient.

Experts say this is a step forward for precision medicine. It allows surgeons to be more careful with healthy tissue. It helps reduce the chance of cancer returning later.

If you are facing stomach cancer surgery, ask your doctor about this. It might not be ready for every hospital right now. You should discuss if this test fits your specific case.

This study looked at past data from one location. It did not test every type of stomach cancer. Some rare cases might not show up on this test.

Larger studies are needed to confirm these results. The sample size was decent but not huge. We need more data to be fully sure.

Doctors will run more trials to make this standard. They want to ensure it works for everyone, not just some. Approval from health agencies will take time and careful review.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundIn the realm of sentinel lymph node navigation surgery for cancer patients, the intraoperative pathological examination of sentinel lymph nodes is of paramount importance in delineating the extent of surgical intervention. This study aimed to analyze the feasibility of frozen section of sentinel lymph node in early gastric cancer.MethodsA retrospective analysis of data prospectively collected was undertaken from a tertiary hospital. Patients with early gastric cancer were treated by sentinel lymph node biopsy followed by lymph node dissection. Primary outcome variables were the failure rate of frozen section identification and the incidence of metastasis in non-sentinel lymph nodes.ResultsOf the 238 patients who underwent sentinel lymph node pelvic dissection, 30 were identified as having lymph node metastasis upon permanent pathological examination. Thirteen patients exhibited macrometastasis confirmed in both frozen and formalin-fixed and paraffin-embedded (FFPE) sections. Patients with negative sentinel lymph nodes in frozen sections but evidence of micrometastasis in FFPE sections did not experience lymph node recurrence during the follow-up period. In instances where tumor-positive lymph nodes were identified in frozen sections, metastasis in non-sentinel lymph nodes was detected in the paraffin blocks (8.3%, 2/24).ConclusionsThe single-section hematoxylin and eosin staining method proves efficacious in detecting macrometastatic tumors through intraoperative pathological examination. Should the frozen section result be definitively negative, sentinel basin dissection can be executed with safety. Conversely, in the absence of such confirmation, the standard surgical approach is advisably pursued.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.