Detection of Sentinel Node Micrometastasis by Step Section and Immunohistochemistry in Patients With Prostate Cancer

Fukuda, Mamoru; Egawa, Masayuki; Imao, Tetsuya; Takashima, Hiroshi; Yokoyama, Keitaro; Namiki, Mikio

doi:10.1016/j.juro.2006.11.085

Cited by 35 publications

(32 citation statements)

References 18 publications

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“…In combination with the 3D information that SPECT-CT provided, this improvement may render initial exploration with the LGP in vivo redundant, provided that the fluorescence-based SN identification rate equals that of its radioactive counterpart. This is attractive because fluorescence does not suffer from the shine-through phenomenon from the tracer deposits in the prostate, as is the case for the radio-guided approach [18].…”

Section: Discussionmentioning

confidence: 99%

Optimisation of Fluorescence Guidance During Robot-assisted Laparoscopic Sentinel Node Biopsy for Prostate Cancer

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Optimisation of Fluorescence Guidance During Robot-assisted Laparoscopic Sentinel Node Biopsy for Prostate Cancer

et al. 2014

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“…Extended serial sectioning and immunohistochemistry using anti-cytokeratin antibodies has been shown to increase the detection of metastases that are ≤ 2 mm in diameter (20,21). This has also been illustrated by computer simulations of SNs in breast cancer (22), and confirmed by another breast cancer study which showed that more extensive pathological analysis alone resulted in a 13% increase in detection of micrometastases (23).…”

Section: Discussionmentioning

confidence: 78%

Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer

Kjölhede

Bratt

Guðjónsson

et al. 2014

Scandinavian Journal of Urology

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Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer.Kjölhede, Henrik; Bratt, Ola; Gudjonsson, Sigurdur; Sundqvist, Pernilla; Liedberg, Fredrik Link to publication Citation for published version (APA): Kjölhede, H., Bratt, O., Gudjonsson, S., Sundqvist, P., & Liedberg, F. (2015). Simplified intraoperative sentinelnode detection performed by the urologist accurately determines lymph-node stage in prostate cancer. Scandinavian Journal of Urology, 49(2), 97-102. DOI: 10.3109/21681805.2014.968867 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal is currently an extended pelvic lymph node dissection (ePLND), which detects the majority, but not all, of regional lymph node metastases. As an alternative to ePLND, sentinel node (SN) dissection with preoperative isotope injection and imaging has been reported. The objective was to determine whether intraoperative SN detection with a simplified protocol can accurately determine lymph node stage in prostate cancer patients. Materials and methods:Patients with biopsy-verified high-risk prostate cancer with tumour stage T2-3 were included in the study. All patients underwent both ePLND and SN detection. 99m Tc-marked nanocolloid was injected peritumourally by the operating urologist after induction of anaesthesia just prior to surgery. SNs were detected both in-vivo and ex-vivo intraoperatively using a gamma probe. SNs and metastases and their locations were recorded. Sensitivity and specificity were calculated.Results: At least one SN was detected in 72 (87%) of the 83 patients. In 13 (18%) of these 72 patients SNs were detected outside the ePLND template. In six of these 13 patients, the SNs from outside the template contained metastases, which proved to be the only metastases in two. For 12 patients the only metastatic deposit found was a micrometastasis (≤ 2 mm) in a SN. In the 72 patients with detectable SNs, pathological analysis of the SNs correctly categorised 71 and ePLND 70 patients. Conclusions:This protocol yielded results comparable to the commonly used technique of SN detection, but with more cases of non-detection.

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“…4,10,33,34 In patients with a high body mass index, this beneficial property was found to be most prominent. 12 SPECT-CT can complete the preoperative imaging procedure by providing additional 3-D anatomical information with regard to the location of the radioactive hotspots 34 (Fig.…”

Section: Spect-ct Imagingmentioning

confidence: 98%

“…The detection rate of the SN procedure ranged 76-100%. 5,8,9,12,23,25,29,31,33,36,[43][44][45][46][47][48] A total of 13-75% of the patients showed one or more SN outside the limited PLND template. In addition, SN were detected outside the standard PLND in 51.8-76.9% of the patients with positive LN.…”

Section: Clinical Implications Of Sn Biopsy For Pcamentioning

confidence: 99%

“…In 4.1-25% of patients, SN outside the ePLND template were found, whereas 3.5-17% of patients with positive LN had SN metastases outside the ePLND template. 5,7,8,[23][24][25]27,28,31,33,37,[43][44][45]47,[49][50][51][52][53][54] In these studies, the median percentage of positive LN was 20.4% (range 4.7-50) with a FN rate of 1% (range 0-20), respectively.…”

Section: Clinical Implications Of Sn Biopsy For Pcamentioning

confidence: 99%

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Advances in sentinel node dissection in prostate cancer from a technical perspective

et al. 2015

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Abbreviations & Acronyms ePLND = extended pelvic lymph node dissection FN = false negative ICG = indocyanine green LN = lymph node MRI = magnetic resonance imaging NIR = near-infrared NR = not reported PCa = prostate cancer PET = positron emission tomography PLND = pelvic lymph node dissection SN = sentinel node SPECT-CT = single-photon emission computed tomography combined with computed tomography TRUS = transrectal ultrasound Abstract: The most important feature of sentinel node biopsy for prostate cancer procedure is that staging can be improved. Sentinel nodes might be found outside the extended pelvic lymph node dissection template what renders the sentinel node additive of extended pelvic lymph node dissection. At the same time, staging within the template can be further refined. We reviewed the literature regarding the sentinel node biopsy procedure for prostate cancer. PubMed and Embase were searched for all Englishlanguage publications from January 1999 to September 2014 by using the keywords as "prostate cancer" and "sentinel lymph node" plus "biopsy" "dissection" and/or "procedure." The present review discusses step-by-step sentinel node biopsy for prostate cancer. Topics of discussion are: (i) preoperative sentinel node mapping (tracers and imaging); (ii) intraoperative sentinel node identification (surgical procedure and outcome); and (iii) novelties to improve sentinel node identification (pre-and intraoperative approaches). Conventional sentinel node mapping is carried out after the injection of a 99m Tc-based tracer and subsequent preoperative imaging; for example, lymphoscintigraphy and singlephoton emission computed tomography/computed tomography. This approach allowed the detection of sentinel nodes outside the extended lymph node dissection template in 3.6-36% of men with intermediate-and high-risk prostate cancer. Hereby, an overall false negative rate of sentinel nodes was reported between 0% and 24.4%. To further refine the intraoperative sampling procedure, novel imaging methods such as fluorescence imaging have been introduced. Prospective randomized comparison studies are required to confirm the added benefit of sentinel template directed nodal dissection. A proper and obtainable end-point of such a study could be the number of removed positive nodes for carrying out nodal dissection with or without sentinel template directed dissection. Similarly, the clinical impact of novel imaging technologies requires further investigation.

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Detection of Sentinel Node Micrometastasis by Step Section and Immunohistochemistry in Patients With Prostate Cancer

Abstract: The validity of the sentinel node concept in conjunction with the detection of micrometastases was considered to be high. Furthermore, it was suggested that the efficacy of metastasis diagnosis may also be enhanced, especially in patients receiving neoadjuvant hormone therapy.

Cited by 35 publications

References 18 publications

Optimisation of Fluorescence Guidance During Robot-assisted Laparoscopic Sentinel Node Biopsy for Prostate Cancer

Optimisation of Fluorescence Guidance During Robot-assisted Laparoscopic Sentinel Node Biopsy for Prostate Cancer

Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer

Advances in sentinel node dissection in prostate cancer from a technical perspective

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