LECS Combined With LSNNS for Early Gastric Cancer (LENS Trial)

Condition(s) studied

Investigational drug(s) / intervention(s)

Procedure: LECS combined with LSNNS: Patients with cT1N0M0 early gastric cancer will undergo Laparoscopic and Endoscopic Cooperative Surgery (LECS) combined with Laparoscopic Sentinel Node Navigation Surgery (LSNNS).Sentinel Lymph Node Biopsy (LSNNS): Indocyanine green will be injected submucosally via endoscopy or subserosally via laparoscopy around the tumor site. After a 20-minute tracer waiting period, fluorescent sentinel lymph nodes (SNs) will be navigated and harvested laparoscopically for intraoperative frozen section pathological evaluation. Surgical Procedure Based on SN Status:If intraoperative SN status is negative (SBN-): Patients will undergo stomach-preserving surgery using non-exposed LECS techniques, primarily Non-exposed Endoscopic Wall-inversion Surgery (NEWS). If intraoperative SN status is positive (SBN+): Patients will immediately convert to standard laparoscopic gastrectomy with formal D1/D1+ lymph node dissection.

Study summary

Early gastric cancer (EGC) is traditionally treated with either endoscopic resection or standard laparoscopic gastrectomy with formal lymph node dissection. However, endoscopic resection cannot evaluate or treat regional lymph node metastasis, whereas standard surgery significantly impairs postoperative gastric physiological function and patient quality of life (QoL). The LENS trial is a prospective, single-arm clinical study designed to evaluate the feasibility, safety, and long-term efficacy of Laparoscopic and Endoscopic Cooperative Surgery (LECS) combined with Laparoscopic Sentinel Node Navigation Surgery (LSNNS) using Indocyanine Green (ICG) fluorescence tracing for patients with cT1N0M0 early gastric cancer. In this trial, eligible patients will undergo intraoperative sentinel lymph node (SN) biopsy guided by ICG. Patients with negative SN status will receive stomach-preserving surgery (primarily Non-exposed Endoscopic Wall-inversion Surgery, NEWS), while those with positive SN status will convert to standard laparoscopic gastrectomy. The primary goal is to confirm whether this combined procedure provides long-term oncological safety comparable to standard radical gastrectomy, while significantly improving postoperative gastric function, nutritional status, and quality of life.

Eligibility

Primary outcome measure(s)

• 3-Year Disease-Free Survival (DFS) — 3 years post-operation
  DFS is defined as the proportion of patients who survive without early gastric cancer recurrence (local, regional, or distant) or death from any cause at 3 years after surgery.

Trial sites (1)

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