RT-PCR and immunohistochemical evaluation of sentinel lymph nodes after<i>in vivo</i>mapping with Patent Blue V in colon cancer patients

Kelder, Wendy; Berg, Anke van den; Leij, Judith van der; Bleeker, Wim; Tiebosch, A.T.M.G.; Grond, J.; Baas, Peter C.; Plukker, John

doi:10.1080/00365520600554469

Cited by 12 publications

(4 citation statements)

References 38 publications

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“…The selection process is described in Figure 1 [ 40 ]. Several studies appearing to meet inclusion criteria were excluded for the following reasons: doubled patient data [ 7 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ,…”

Section: Resultsmentioning

confidence: 99%

Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies

Lucas

Melling

Giannou

et al. 2023

Cancers

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An optimized lymph node yield leads to better survival in colon cancer, but extended lymphadenectomy is not associated with survival benefits. Lymphatic mapping shows several colon cancers feature aberrant drainage pathways inducing local recurrence when not resected. Currently, different protocols exist for lymphatic mapping procedures. This meta-analysis assessed which protocol has the best capacity to detect tumor-draining and possibly metastatic lymph nodes. A systematic review was conducted according to PRISMA guidelines, including prospective trials with in vivo tracer application. The risk of bias was evaluated using the QUADAS-2 tool. Traced lymph nodes, total resected lymph nodes, and aberrant drainage detection rate were analyzed. Fifty-eight studies met the inclusion criteria, of which 42 searched for aberrant drainage. While a preoperative tracer injection significantly increased the traced lymph node rates compared to intraoperative tracing (30.1% (15.4, 47.3) vs. 14.1% (11.9, 16.5), p = 0.03), no effect was shown for the tracer used (p = 0.740) or the application sites comparing submucosal and subserosal injection (22.9% (14.1, 33.1) vs. 14.3% (12.1, 16.8), p = 0.07). Preoperative tracer injection resulted in a significantly higher rate of detected aberrant lymph nodes compared to intraoperative injection (26.3% [95% CI 11.5, 44.0] vs. 2.5% [95% CI 0.8, 4.7], p < 0.001). Analyzing 112 individual patient datasets from eight studies revealed a significant impact on aberrant drainage detection for injection timing, favoring preoperative over intraoperative injection (OR 0.050 [95% CI 0.010–0.176], p < 0.001) while indocyanine green presented itself as the superior tracer (OR 0.127 [95% CI 0.018–0.528], p = 0.012). Optimized lymphatic mapping techniques result in significantly higher detection of aberrant lymphatic drainage patterns and thus enable a personalized approach to reducing local recurrence.

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Section: Resultsmentioning

confidence: 99%

Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies

Lucas

Melling

Giannou

et al. 2023

Cancers

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“…[ 15 ] In another study, by using IHC and PCR, Kelder could detect 33% of MM/ITCs in SLNs. [ 16 ] Using IHC (CK-CEA), Thomas was able to detect MM/ITCs in 3% of the SLNs. [ 17 ] In a study conducted by Bembenek et al ., both SLNs and non-SLNs were evaluated by using serial section and IHC methods and 39% of MM/ITCs were detected in 33 patients with lymph node negative involvement.…”

Section: Discussionmentioning

confidence: 99%

Comparing the efficacy of routine HandE staining and cytokeratin immunohistochemical staining in detection of micro-metastasis on serial sections of dye-mapped sentinel lymph nodes in colorectal carcinoma

et al. 2016

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“…Targeted LN examination by mapping of the most proximal LN (sentinel LN) improves the staging accuracy for colon cancer [43,44]. In LN mapping, however, there are inconsistencies [45-47] that may be attributable to inadequate standardization, training, and interpretation of micro-metastases and to skip metastases [43,48]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

et al. 2011

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BackgroundAlthough evaluation of at least 12 lymph nodes (LNs) is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs.MethodsTo evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected.ResultsFor patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91), but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64), examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87) and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26) decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p < 0.0001). For Stage II and III colon cancers, there was improved survival and a decreased risk of recurrence with an increased number of LNs examined, regardless of the cutoff-points. Examination of ≥7 or ≥12 LNs had similar outcomes, but there were significant outcome benefits at the ≥20 cutoff-point only for Stage II patients. For Stage III patients, examination of 6 additional LNs detected one additional positive LN.ConclusionsThus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

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RT-PCR and immunohistochemical evaluation of sentinel lymph nodes afterin vivomapping with Patent Blue V in colon cancer patients

Abstract: The SLN concept in colon carcinoma using Patent Blue V is feasible and accurate. It leads to upstaging of nodal status in 33% of patients when IHC and PCR techniques are combined. Therefore, the clinical value of SLN should be the subject of further studies.

Cited by 12 publications

References 38 publications

Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies

Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies

Comparing the efficacy of routine HandE staining and cytokeratin immunohistochemical staining in detection of micro-metastasis on serial sections of dye-mapped sentinel lymph nodes in colorectal carcinoma

Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

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