Sentinel Lymph Node Biopsy in Colon Cancer

Bembenek, A.; Rosenberg, Robert D.; Wagler, Elke; Gretschel, Stephan; Sendler, A.; Siewert, J. R.; Nährig, Jörg; Witzigmann, Helmut; Hauss, Johann; Knorr, Christian; Dimmler, Arno; Gröne, Jörn; Buhr, H. J.; Haier, Jörg; Herbst, Hermann; Tepel, Juergen; Siphos, Bence; Kleespies, Axel; Koenigsrainer, Alfred; Stoecklein, Nikolas H.; Horstmann, O.; Grützmann, Robert; Imdahl, A.; Svoboda, Daniel; Wittekind, Christian; Schneider, Wolfgang; Wernecke, Klaus‐Dieter; Schlag, Peter M.

doi:10.1097/01.sla.0000250428.46656.7e

Cited by 125 publications

(101 citation statements)

References 28 publications

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“…In the two studies (n ¼ 25, 57) that used both radiocolloid and blue dye, the identification rate was 88% and 98% and the false negative rate was 45% and 17% [51]. A recent study that used blue dye only to identify the sentinel node found that a high false negative rate was associated with a higher body mass index (>24 kg/m 2 ) [53]. In addition, experience of the unit (<22 cases vs. >22 cases) is also associated with sentinel node identification rate [53], mirroring the melanoma [54] and breast cancer experience [55].…”

Section: Lymphatic Mapping and Ultrastaging Lymph Nodes In Colon Cancermentioning

confidence: 99%

“…A recent study that used blue dye only to identify the sentinel node found that a high false negative rate was associated with a higher body mass index (>24 kg/m 2 ) [53]. In addition, experience of the unit (<22 cases vs. >22 cases) is also associated with sentinel node identification rate [53], mirroring the melanoma [54] and breast cancer experience [55]. Finally, aberrant lymphatic drainage or drainage to a lymph node in an area outside of the standard lymphadenectomy was most commonly to nodes located deep at the base of the mesentery and occurred 0-36% of the time [51].…”

Section: Lymphatic Mapping and Ultrastaging Lymph Nodes In Colon Cancermentioning

confidence: 99%

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Clinically important aspects of lymph node assessment in colon cancer

Wright

Law

Berry

et al. 2009

Journal of Surgical Oncology

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There has been considerable discussion in the literature regarding the importance and validity of lymph node retrieval and lymph node count for patients with colon cancer. In this article we summarize the importance of lymph node resection and assessment in contemporary colon cancer care, key clinical determinants of lymph node assessment, and discuss the role of lymph node assessment as a quality marker in colon cancer care.

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Section: Lymphatic Mapping and Ultrastaging Lymph Nodes In Colon Cancermentioning

confidence: 99%

Section: Lymphatic Mapping and Ultrastaging Lymph Nodes In Colon Cancermentioning

confidence: 99%

Clinically important aspects of lymph node assessment in colon cancer

Wright

Law

Berry

et al. 2009

Journal of Surgical Oncology

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“…FI may offer better tissue contrast, facilitating detection in deep anatomic regions such as the abdomen, and is easy and safe to perform (13,14,17). Furthermore, ICG-FI is not influenced by the patient's BMI nor by lymphatic invasion, as has been shown for conventional methods, and has been shown to increase SLN detection in comparison with standard techniques (16,18). Although the ex vivo blue dye technique in SLN detection in CRC is well documented in the literature and has been demonstrated to be as effective and sensitive as the in vivo technique (19,20), no study has yet evaluated the role of ICG-FI using the ex vivo technique for SLN detection.…”

Section: Discussionmentioning

confidence: 94%

Sentinel Lymph Node Detection by Blue Dye Versus Indocyanine Green Fluorescence Imaging in Colon Cancer

Liberale

Vankerckhove

Galdón

et al. 2016

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Abstract. Background In patients with colorectal cancer (CRC), the accurate establishment of the pathological status of tumor-draining mesenteric lymph nodes (LN) is of central importance for therapeutic management. In patients with stage III disease with demonstrated LN metastases, adjuvant systemic chemotherapy is indicated, reducing the risk of recurrence and improving long-term overall survival (1). The accuracy of mesenteric nodal staging depends primarily on the number of resected LN, and the seventh American Joint Committee on Cancer (AJCC) edition recommends harvesting and analysis of at least 12 to 14 LN for correct staging (2). Despite this, 20-30% of patients with no LN metastases demonstrated at pathology (pN0), and therefore classified as stage II, still develop recurrent disease (3). These recurrences could potentially be associated with unrecognized locoregional nodal metastases, which could lead to understaging and undertreatment.The sentinel lymph node (SLN) is defined as the first LN draining the primary tumor. In melanoma and breast cancer, it has been shown that pathological status of the SLN is indicative of the risk of nodal metastases, thus providing an indication for lymphadenectomy when SLN pathological examination is positive and for avoiding mutilating surgery when it is negative (4, 5). The concept, and potential utility, of the SLN is different in CRC since mesenteric lymphadenectomy is systematically performed during surgery for the primary tumor. In patients with CRC, the particular contribution of SLN examination could be to focus the pathological analysis specifically on draining LNs in order to improve the sensitivity for cancer cell detection by the use of advanced methods, such as serial sectioning, immunohistochemistry (IHC), and molecular analyses such as reverse transcriptase polymerase chain reaction (RT-PCR) to increase pathological staging (6).Accordingly, a recent meta-analysis concluded that the use of SLN examination allowed for nodal up-staging of patients with CRC, providing a potential benefit (7). However, the technique of SLN analysis is still not widely used in patients with CRC. This could be related to the variability of the sensitivity of techniques for SLN detection which ranges from 33% to 100%, to the risk of missed metastases, and also to uncertainty related to the clinical significance and prognostic value of nodal micrometastases in CRC (7-9).Recently, fluorescence imaging (FI) using indocyanine green (ICG) has emerged as a new technique for SLN detection in various tumors (10)(11)(12). Only few studies have 4853

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“…Furthermore, in advanced disease, SN study is less useful as patients will receive adjuvant chemotherapy anyway. In a recent multi-centric trial, a cut-off level of 22 patients was defined to increase detection rate from 76.4% to 91.0% [43].…”

Section: Discussionmentioning

confidence: 99%