Detection of alternative subpleural lymph flow pathways using indocyanine green fluorescence

Takeda, Aya; Watanabe, Yui; Nagata, Toshiyuki; Aoki, Masaya; Umehara, Tadashi; Suzuki, Shoichiro; Kamimura, Go; Wakida, Kazuhiro; Otsuka, T.; Yokomakura, Naoya; Kariatsumari, Kota; Sakasegawa, K; Nakamura, Yoshihiro; Sato, Masami

doi:10.1007/s00595-018-1631-1

Cited by 17 publications

(5 citation statements)

References 27 publications

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“…The inconsistency between different research studies [27, 28] could result from the different criteria of the definition as “central location” and the different target population. Takeda et al also found that peripheral tumors are more likely to have N2 metastasis by subpleural lymph drainage pathways [29].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

Zhang

Pang

et al. 2019

Journal of Immunology Research

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Background Lymph node status of clinical T1 (diameter ≤ 3 cm) lung cancer largely affects the treatment strategies in the clinic. In order to assess lymph node status before operation, we aim to develop a noninvasive predictive model using preoperative clinical information. Methods We retrospectively reviewed 924 patients (development group) and 380 patients (validation group) of clinical T1 lung cancer. Univariate analysis followed by polytomous logistic regression was performed to estimate different risk factors of lymph node metastasis between N1 and N2 diseases. A predictive model of N2 metastasis was established with dichotomous logistic regression, externally validated and compared with previous models. Results Consolidation size and clinical N stage based on CT were two common independent risk factors for both N1 and N2 metastases, with different odds ratios. For N2 metastasis, we identified five independent predictors by dichotomous logistic regression: peripheral location, larger consolidation size, lymph node enlargement on CT, no smoking history, and higher levels of serum CEA. The model showed good calibration and discrimination ability in the development data, with the reasonable Hosmer-Lemeshow test (p = 0.839) and the area under the ROC being 0.931 (95% CI: 0.906-0.955). When externally validated, the model showed a great negative predictive value of 97.6% and the AUC of our model was better than other models. Conclusion In this study, we analyzed risk factors for both N1 and N2 metastases and built a predictive model to evaluate possibilities of N2 metastasis of clinical T1 lung cancers before the surgery. Our model will help to select patients with low probability of N2 metastasis and assist in clinical decision to further management.

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Section: Discussionmentioning

confidence: 99%

Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

Zhang

Pang

et al. 2019

Journal of Immunology Research

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“…In recent years, the efficacy of near-infrared (NIR) imaging using indocyanine green (ICG) fluorescence has been reported as a method for visualizing lymphatic flow in various areas. [18][19][20][21][22] ICG is a water-soluble compound with a molecular weight of 774.96 Daltons. ICG binds rapidly to serum proteins when administered topically into the intestinal submucosa.…”

Section: Principales Resultados Medidasmentioning

confidence: 99%

Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical Stage II/III Middle-Lower Rectal Cancer: A Propensity Score-Matched Cohort Study

Ohya

Watanabe

Suwa

et al. 2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND:The examination of the efficacy of nearinfrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection remains insufficient. OBJECTIVE:The aim of this study was to examine whether near-infrared imaging contributed to an increase in the total number of harvested lateral pelvic lymph nodes in laparoscopic lateral pelvic lymph node dissection.DESIGN: This was a retrospective, multi-institutional study with propensity score matching. SETTINGS:We conducted this study within the framework of the Yokohama Clinical Oncology Group in Japan. PATIENTS:The study population included consecutive patients with middle-low rectal cancer (clinical stage II to III) who underwent laparoscopic lateral pelvic lymph node dissection between January 2013 and February 2018. MAIN OUTCOME MEASURES:The total number of harvested lateral pelvic lymph nodes was compared in laparoscopic lateral pelvic lymph node dissection with and without near-infrared imaging.RESULTS: A total of 172 eligible patients were included; 84 of these patients underwent laparoscopic surgery with near-infrared imaging. After propensity score matching, 58 patients were matched in each of the near-infrared and the non-near-infrared groups. The operation time in the near-infrared group was significantly longer than that in the non-near-infrared group (426 vs 369 min), and the amount of intraoperative blood loss in the near-infrared group was significantly smaller than that in the non-near-infrared group (13 vs 110 mL). The total number of harvested lateral pelvic lymph nodes in the near-infrared group was significantly higher than that in the non-near-infrared group (14 vs 9). There were no significant differences in the postoperative complication rates of the 2 groups. LIMITATIONS:The limitations of the present study include its retrospective design. CONCLUSIONS:This study revealed that laparoscopic lateral pelvic lymph node dissection combined with near-infrared imaging could increase the total number of harvested lateral pelvic lymph nodes without impairing functional preservation. See Video Abstract at http:// links.lww.com/DCR/B800. This study was registered with the Japanese Clinical Trials Registry as UMIN000041372 (http://www.umin.ac.jp/ctr/ index.htm).

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“…However, all lymph node recurrences were observed outside the usual dissection area. We speculate that cancer cells invade some lymph flows at a higher rate (12), because centrally located lung cancer is very close to mediastinal structures, and some cancer cells might spread easily through lymph flow pathways under the visceral and mediastinal pleura (13) cancer cell-positive pleural or pericardial effusion at the time of operation, three had pleural dissemination and one had carcinomatous pericarditis during the follow-up period. Recurrence in the pleura or pericardium may be due to remnant cancer cells in the mediastinal pleura or pericardium that could not be noticed during the operation.…”

Section: Discussionmentioning

confidence: 98%

Elevation of Neutrophil-to-Lymphocyte Ratio Is a Significant Poor Prognostic Factor in Completely Resected Centrally Located Lung Squamous Cell Carcinoma

Tsukioka

Izumi

Komatsu

et al. 2022

In Vivo

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Background/Aim: The neutrophil-to-lymphocyte ratio (NLR) plays key roles in cancer growth. This study aimed to identify novel prognostic factors in patients who underwent complete resection of centrally located lung squamous cell carcinoma. Patients and Methods: We retrospectively investigated the clinical courses of 45 patients who underwent sleeve lobectomy or pneumonectomy for centrally located squamous cell carcinoma. Results: High NLR (p<0.001) and pathological T3/4 (p=0.008) were significant poor prognostic factors according to univariate analysis. Patients with pathological N2 had poor prognosis; however, there was no significant difference (p=0.095). Among these factors, only high NLR (p=0.003) was an independent poor prognostic factor according to multivariate analysis. Of the 23 patients with high NLR, 11 (49%) had recurrence, whereas in the 22 patients without high NLR, only two (9%) had recurrence. Conclusion: High NLR is an independent poor prognostic factor in centrally located lung squamous cell carcinoma. Our findings may guide the selection of optimal treatments for this subgroup of patients.

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Detection of alternative subpleural lymph flow pathways using indocyanine green fluorescence

Cited by 17 publications

References 27 publications

Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

Near-Infrared Imaging Using Indocyanine Green for Laparoscopic Lateral Pelvic Lymph Node Dissection for Clinical Stage II/III Middle-Lower Rectal Cancer: A Propensity Score-Matched Cohort Study

Elevation of Neutrophil-to-Lymphocyte Ratio Is a Significant Poor Prognostic Factor in Completely Resected Centrally Located Lung Squamous Cell Carcinoma

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