A multicenter study of using carbon nanoparticles to show sentinel lymph nodes in early gastric cancer

Yan, Jun; Zheng, Xiaojiao; Liu, Zhangyuanzhu; Yu, Jiang; Deng, Zhenwei; Xue, Fangqing; Zheng, Yu; Chen, Feng; Shi, Hong; Chen, Gang; Lu, Jianping; Cai, Lisheng; Cai, Mengxin; Gao, Xiang; Hong, Yunfeng; Chen, Wenbo; Li, Guoxin

doi:10.1007/s00464-015-4358-8

Cited by 38 publications

(43 citation statements)

References 29 publications

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“…However, no ideal materials have been found due to the limitation of their staining efficiency, the relatively complicated lymphatic flow of the gastric system, radiation injury, and expense. Carbon nanoparticles (CN) are one of the most commonly used nanoparticles to trace LNs in some tumors because they are inexpensive and widely available (43)(44)(45). Recently, LN labeling with CN was applied to GC and can improve the number of RLNs and the detection of MLNs (46).…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, a more precise oncologic prognostic assessment is provided by increasing the number of RLNs (21.1 vs. 8.0, p < 0.001) using the dye-tracing method. Furthermore, in the CN group, the mean time for LN retrieval was shorter than that in the control group (27.6 vs. 34.6 min, p < 0.001) (45). Li et al conducted a prospective randomized trial to evaluate the efficiency and safety of CN for retrieving LNs in advanced GC (47).…”

Section: Discussionmentioning

confidence: 99%

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The Methods of Lymph Node Examination Make a Difference to Node Staging and Detection of N3b Node Status for Gastric Cancer

Chen

et al. 2020

Front. Oncol.

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Background: The number of retrieved lymph nodes (RLNs) affects the likelihood of detecting metastatic lymph nodes (MLNs) for gastric cancer (GC), but the retrieval of LNs is not satisfactory worldwide. There is no standard for LN examination.Methods: We retrospectively analyzed 2,163 patients diagnosed with GC who underwent surgery at Nanfang Hospital between October 2004 and September 2016. According to the methods of LN examination, patients were classified into two groups: LN detection by pathologists (pathologist group) and LN examination by surgicopathologic team (surgicopathologist group). The relationship between RLNs and LN staging accuracy as well as the factors influencing the detection of MLNs were evaluated.Results: There were 472 males in pathologist group and 467 males in surgicopathologist group. The number of RLNs and MLNs in surgicopathologist group was significantly higher than that in pathologist group (RLNs: 53.8 ± 20.9 vs. 18.8 ± 11.5, p < 0.001; MLNs: 5.6 ± 9.8 vs. 3.9 ± 5.7, p < 0.001). Notably, the detection of N3b node status was significantly improved in surgicopathologist group [83 (11.9%) vs. 34 (4.8%), p < 0.001]. Additionally, the detection rate of N3b status gradually increased from 0 in patients with 1-16 RLNs to 16.6% in patients with more than 49 RLNs. The MLNs detected increased gradually from 2.3 ± 3.0 in patients with 1-16 RLNs to 7.3 ± 11.7 in patients with more than 49 RLNs. Univariate and multivariate analyses indicated that LN examination by surgicopathologic team, more advanced pT, tumor size ≥5 cm and combined organ(s) resection were related to detecting more MLNs. Conclusions:The retrieval of nodes immediately postoperatively by the surgicopathologic team could significantly improve the number of RLNs, detect more MLNs, and screen more patients with N3b node status.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Methods of Lymph Node Examination Make a Difference to Node Staging and Detection of N3b Node Status for Gastric Cancer

Chen

et al. 2020

Front. Oncol.

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“…10,11 The reason is that CNPs cannot enter the blood vessel and cause systemic adverse reactions. 10,11 Studies about CNPs in breast cancer, endometrial cancer, and gastric cancer have not reported adverse reactions, [18][19][20] while adverse reactions such as allergic reactions, pruritus, and rashes are reported when using the blue dye. 15,16 In recent years, ICG fluorescence has been the main recommended method in studies, among which the prospective FILM trial reported an overall detection rate of 98%.…”

Section: Discussionmentioning

confidence: 99%

Detection of sentinel lymph node in laparoscopic surgery for uterine cervical cancer using carbon nanoparticles

Wang

Zhao

Yuan

et al. 2020

Journal of Surgical Oncology

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Background and Objectives Carbon nanoparticles (CNPs) has been widely confirmed the efficiency in sentinel lymph node (SLN) mapping for various solid tumors. This study aims to explore the feasibility and effectiveness of CNPs during laparoscopic surgery for cervical cancer. Methods We analyzed 45 women with stage IB1‐IIA1 cervical cancer who underwent SLN mapping using CNPs during laparoscopic surgery. The effectiveness of CNPs was evaluated by the detection rate and accuracy parameters. Factors associated with SLN laterality and SLNs localizations were analyzed. Results The overall and bilateral detection rate was 93.3% (42/45) and 60.0% (27/45), respectively. Elevated body mass index was associated with decreased bilateral detection rate (P = .015). A total of 225 SLNs were harvested, with a mean number of 5.0 ± 3.6. A total of 81.3% of SLNs were in expected localizations including external iliac (39.1%), internal iliac (25.8%), and obturator (16.4%) regions, while 18.7% in unusual localizations including common iliac (10.7%), parametrial (7.6%), and presarcal (0.4%) regions. None positive lymph node was found in non‐SLNs with a false‐negative rate of 0%. Conclusion Laparoscopic SLN mapping with CNPs appears to be simple and efficient for patients with early‐stage cervical cancer.

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“…According to previous study, lymphatic fondness of CNs were benefit from not only its special molecular structure but also phagocytosed by macrophage [19]. Furthermore, the long-term staining and tracing of CNs provide a feasible technique to explore the relationship between lymphovascular invasion and the regression of positive nodes.…”

Section: Discussionmentioning

confidence: 99%

Long-term Tracing of Carbon Nanoparticles for Axillary Lymph Node Dissection in Patients with Fusion Lymph Nodes before Neoadjuvant Chemotherapy

Song

Wang

et al. 2019

Preprint

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Background: The regression model of positive nodes in breast cancer after neoadjuvant chemotherapy (NAC) remains controversial. This study aimed to investigate this regression model by injecting and tracing carbon nanoparticles (CNs) into the fusion node prior to NAC in patients with breast cancer.Methods: Guided by ultrasound, 0.3 mL of CNs suspension was injected in a fusion node prior to NAC in 110 patients with local advanced breast cancer. Patients underwent breast surgery and total axillary lymph node dissection following 2-6 cycles of NAC. The distribution by intercostobrachial nerves (ICBN) of positive nodes, black-stained nodes and lymphovascular invasion was investigated by response to NAC.Results: When patients were ranked by response to NAC (from sensitive to resistance), the number of positive nodes increased, as did the proportion of lymphovascular invasion, the number of blackstained nodes decreased. A significantly negative relationship was found between the number of positive nodes and the number of black-stained nodes (p < 0.001). The positive nodes in patients with sensitive consequence followed the rule from under the ICBN to above the ICBN. However, there was counter-example (skip metastasis) in the patients with resistance result.Conclusion: The regression model of positive nodes follows the rule from upper to under, inner to outer in the patients with sensitive consequence to NAC. Long-term staining and tracing by CNs might provide an acceptable and feasible technique to investigate the regression model of positive nodes, and would be a potential method for NAC-treated patients by using of ICBN.Trial registration: NCT 03355261. Retrospectively registered on November 28, 2017. SLNB after NAC as unacceptable when compared with the <5% rate produced by the pioneers of SLNB [3]. In fact, about 9% of patients with positive nodes and T0-2 breast cancer have residual positive nodes in the Level III region after NAC [4]. Therefore, it is essential to explore the regression model post-NAC in patients who are node-positive prior to NAC.Studies from developed countries suggest that SLNB is a reliable method for lymph node evaluation in NAC-treated patients with breast cancer [5, 6]. However, they did not distinguish or exclude patients who were suspected or proven to harbor axillary metastases before receiving NAC. We speculated that the number of patients with N3 nodes in these studies was small. The proportion of patients in China with advanced stage breast cancer is higher than that in more developed countries [7].Therefore, Chinese surgeons are interested in the feasibility of SLNB for patients with local advanced breast cancer who are treated with NAC. Recent studies suggest that SLNB is technically feasible and accurate enough for axillary staging in initially clinically node-negative breast cancer patients after NAC [8]. Additionally, SLNB is feasible for patients whose axillary lymph nodal status is N1 before NAC; however, SLNB cannot be used as a reliable indicator of non-SLN status in N2-3 p...

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A multicenter study of using carbon nanoparticles to show sentinel lymph nodes in early gastric cancer

Abstract: It is feasible to use carbon nanoparticles to show SLNs in early gastric cancer. Carbon nanoparticles suspension is safe for submucosal injection.

Cited by 38 publications

References 29 publications

The Methods of Lymph Node Examination Make a Difference to Node Staging and Detection of N3b Node Status for Gastric Cancer

The Methods of Lymph Node Examination Make a Difference to Node Staging and Detection of N3b Node Status for Gastric Cancer

Detection of sentinel lymph node in laparoscopic surgery for uterine cervical cancer using carbon nanoparticles

Long-term Tracing of Carbon Nanoparticles for Axillary Lymph Node Dissection in Patients with Fusion Lymph Nodes before Neoadjuvant Chemotherapy

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