{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:01:58Z","timestamp":1786122118339,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"NIH\/NCI Cancer Center","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"https:\/\/ror.org\/00g1d7b60","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objective: To evaluate the feasibility of sentinel lymph node (SLN) identification in distal esophageal and esophagogastric junction (EGJ) adenocarcinoma and determine whether the SLN concept applies to this disease. Methods: Patients undergoing esophagectomy for clinical stage I-IVA esophageal and EGJ adenocarcinoma underwent SLN mapping by near-infrared detection of indocyanine green (ICG) injected via endoscopy before esophagectomy. Lymphatic drainage patterns were recorded, and the first identified nodes (SLNs) were harvested. Standard esophagectomy and lymphadenectomy were performed. SLN status was compared with overall nodal status. Results: Of 90 included patients, 77 received ICG; SLN mapping was successful in 64 (83%). Ten patients had two SLN stations identified; the remainder had one. The most common SLN location was along the left gastric artery (36\/74 [48%]), followed by the paracardial (17\/74 [23%]) and periesophageal (15\/74 [20%]) stations. Seven patients had SLNs positive for metastasis (in one, the SLN was the only positive node; in the rest, metastatic nodes were identified in the same or other stations). Of the 57 patients with negative SLNs, 11 (19%) had \u22651 positive node in the same or different nodal station. The false-negative rate was 61.1%. Conclusions: SLN mapping with ICG is feasible in patients with distal esophageal and EGJ adenocarcinoma, with a high rate of successful node identification. Occult nodal metastasis in patients with negative SLNs limits the reliability of SLN assessment as a determinant for selective lymphadenectomy.<\/jats:p>","DOI":"10.3390\/cancers18162534","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:01:36Z","timestamp":1786089696000},"page":"2534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Prospective Assessment of Near-Infrared Image-Guided Sentinel Lymph Node Identification in Esophageal and Esophagogastric Junction Cancer"],"prefix":"10.3390","volume":"18","author":[{"given":"Daniela","family":"Molena","sequence":"first","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Nobel","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Sewell","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirthavarsini","family":"Manikandan","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9757-1325","authenticated-orcid":false,"given":"Kay See","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Bott","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-8406","authenticated-orcid":false,"given":"Katherine D.","family":"Gray","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Gerdes","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pari","family":"Shah","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8658-3582","authenticated-orcid":false,"given":"Makoto","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-5144","authenticated-orcid":false,"given":"Bernard J.","family":"Park","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita","family":"Sihag","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1016\/j.jtcvs.2018.11.131","article-title":"Prognostic value of neoadjuvant treatment response in locally advanced esophageal adenocarcinoma","volume":"157","author":"Groth","year":"2019","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1001\/jamasurg.2015.4068","article-title":"Association Between Clinically Staged Node-Negative Esophageal Adenocarcinoma and Overall Survival Benefit From Neoadjuvant Chemoradiation","volume":"151","author":"Gabriel","year":"2016","journal-title":"JAMA Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1097\/SLA.0000000000004479","article-title":"A More Extensive Lymphadenectomy Enhances Survival After Neoadjuvant Chemoradiotherapy in Locally Advanced Esophageal Adenocarcinoma","volume":"276","author":"Sihag","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hagens, E.R.C., Van Berge Henegouwen, M.I., and Gisbertz, S.S. (2020). Distribution of Lymph Node Metastases in Esophageal Carcinoma Patients Undergoing Upfront Surgery: A Systematic Review. Cancers, 12.","DOI":"10.3390\/cancers12061592"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.jtcvs.2009.05.039","article-title":"Clinical characteristics, biologic behavior, and survival after esophagectomy are similar for adenocarcinoma of the gastroesophageal junction and the distal esophagus","volume":"138","author":"Leers","year":"2009","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jtcvs.2021.11.094","article-title":"Patterns and influence of nodal metastases after neoadjuvant chemoradiation and R0 resection in esophageal adenocarcinoma","volume":"164","author":"Harrington","year":"2022","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1097\/SLA.0000000000001767","article-title":"Prognostic Significance of the Location of Lymph Node Metastases in Patients With Adenocarcinoma of the Distal Esophagus or Gastroesophageal Junction","volume":"264","author":"Anderegg","year":"2016","journal-title":"Ann. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"doad065","DOI":"10.1093\/dote\/doad065","article-title":"History and evidence for state of the art of lymphadenectomy in esophageal cancer surgery","volume":"37","author":"Schuring","year":"2024","journal-title":"Dis. Esophagus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"255S","DOI":"10.1245\/ASO.2004.12.915","article-title":"Sentinel node detection in Barrett\u2019s and cardia cancer","volume":"11","author":"Burian","year":"2004","journal-title":"Ann. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11605-015-2950-9","article-title":"Can the Risk of Lymph Node Metastases Be Gauged in Endoscopically Resected Submucosal Esophageal Adenocarcinomas? A Multi-Center Study","volume":"20","author":"Boys","year":"2016","journal-title":"J. Gastrointest. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1089\/lap.2016.0523","article-title":"Identification of the Lymphatic Drainage Pattern of Esophageal Cancer with Near-Infrared Fluorescent Imaging","volume":"27","author":"Schlottmann","year":"2017","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4002","DOI":"10.1245\/s10434-023-13317-6","article-title":"Feasibility and Safety of Tailored Lymphadenectomy Using Sentinel Node-Navigated Surgery in Patients with High-Risk T1 Esophageal Adenocarcinoma","volume":"30","author":"Frederiks","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/bcr281","article-title":"History of sentinel node and validation of the technique","volume":"3","author":"Tanis","year":"2001","journal-title":"Breast Cancer Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1001\/archsurg.1992.01420040034005","article-title":"Technical Details of Intraoperative Lymphatic Mapping for Early Stage Melanoma","volume":"127","author":"Morton","year":"1992","journal-title":"Arch. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00000658-199409000-00015","article-title":"Lymphatic Mapping and Sentinel Lymphadenectomy for Breast Cancer","volume":"220","author":"Giuliano","year":"1994","journal-title":"Ann. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.soc.2023.12.014","article-title":"Minimally Invasive Ivor Lewis Esophagectomy","volume":"33","author":"Gray","year":"2024","journal-title":"Surg. Oncol. Clin. N. Am."},{"key":"ref_17","unstructured":"Amin, M.B., Edge, S.B., Greene, F.L., Byrd, D.R., Brookland, R.K., Washington, M.K., Gershenwald, J.E., Compton, C.C., Hess, K.R., and Sullivan, D.C. (2017). Esophagus and esophagogastric junction. AJCC Cancer Staging Manual, Springer. [8th ed.]."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1002\/ueg2.12151","article-title":"Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma","volume":"9","author":"Suzuki","year":"2021","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1007\/s00464-023-10565-1","article-title":"Construction and validation of a risk-scoring model to predict lymph node metastasis in T1b-T2 esophageal cancer","volume":"38","author":"Lin","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/j.jtcvs.2020.10.138","article-title":"Defining low-risk lesions in early-stage esophageal adenocarcinoma","volume":"162","author":"Sihag","year":"2021","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.jss.2006.06.005","article-title":"Area of Nodal Metastasis and Radioisotope Uptake in Sentinel Nodes of Upper Gastrointestinal Cancer","volume":"135","author":"Arima","year":"2006","journal-title":"J. Surg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1002\/cncr.11559","article-title":"Sentinel lymph nodes with technetium\u201499 m colloidal rhenium sulfide in patients with esophageal carcinoma","volume":"98","author":"Kato","year":"2003","journal-title":"Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s12957-016-0866-9","article-title":"Sentinel node biopsy during thoracolaparoscopic esophagectomy for advanced esophageal cancer","volume":"14","author":"Boone","year":"2016","journal-title":"World J. Surg. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"104695","DOI":"10.1016\/j.breast.2026.104695","article-title":"The efficacy of intra-operative injection of [99mTc] labelled colloidal nanoparticles for sentinel lymph nodes identification in breast cancer","volume":"85","author":"Barkai","year":"2026","journal-title":"Breast"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.ejso.2014.02.228","article-title":"Indocyanine green fluorescence-guided sentinel node biopsy: A meta-analysis on detection rate and diagnostic performance","volume":"40","author":"Xiong","year":"2014","journal-title":"Eur. J. Surg. Oncol. (EJSO)"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.jtcvs.2016.04.025","article-title":"Safety and feasibility of near-infrared image-guided lymphatic mapping of regional lymph nodes in esophageal cancer","volume":"152","author":"Hachey","year":"2016","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1245\/s10434-011-1922-x","article-title":"Sentinel Lymph Node Biopsy Using Intraoperative Indocyanine Green Fluorescence Imaging Navigated with Preoperative CT Lymphography for Superficial Esophageal Cancer","volume":"19","author":"Yuasa","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4869","DOI":"10.1245\/s10434-021-09617-4","article-title":"Performance of Indocyanine-Green Imaging for Sentinel Lymph Node Mapping and Lymph Node Metastasis in Esophageal Cancer: Systematic Review and Meta-Analysis","volume":"28","author":"Lacy","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1007\/s00464-021-08551-6","article-title":"Feasibility of sentinel node navigated surgery in high-risk T1b esophageal adenocarcinoma patients using a hybrid tracer of technetium-99 m and indocyanine green","volume":"36","author":"Overwater","year":"2022","journal-title":"Surg. Endosc."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/16\/2534\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:15:23Z","timestamp":1786090523000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/16\/2534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":29,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["cancers18162534"],"URL":"https:\/\/doi.org\/10.3390\/cancers18162534","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}