Sentinel Node Mapping at the Time of COVID-19 Outbreak

Listorti, Chiara; Bogani, Giorgio; Raspagliesi, Francesco; Folli, Secondo

doi:10.1080/08941939.2020.1870180

Cited by 1 publication

(1 citation statement)

References 19 publications

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“…In breast carcinoma, SLNB has replaced axillary dissection as the standard of care staging tool [ 50 ], thus minimizing hospitalization [ 51 ] and long-term pain and lymphedema in breast cancer patients [ 52 ]. This is particularly important in the era of COVID, given the need to reduce hospital visits and exposure of cancer patients to the virus [ 53 ]. This is also relevant to pet owners during this and future pandemics, as decreased postoperative complications in pet dogs will reduce the need for repeated veterinary visits that increase exposure risk to owners.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced and indirect computed tomography lymphangiography accurately identifies the cervical lymphocenter at risk for metastasis in pet dogs with spontaneously occurring oral neoplasia

Goldschmidt

Stewart²,

Ober³

et al. 2023

PLoS ONE

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For dogs with oral tumors, cervical lymph node (LN) metastasis alters treatment and prognosis. It is therefore prudent to make an accurate determination of the clinical presence (cN+ neck) or absence (cN0 neck) of metastasis prior to treatment. Currently, surgical LN extirpation with histopathology is the gold standard for a diagnosis of metastasis. Yet, recommendations to perform elective neck dissection (END) for staging are rare due to morbidity. Sentinel lymph node (SLN) mapping with indirect computed tomography lymphangiography (ICTL) followed by targeted biopsy (SLNB) is an alternative option to END. In this prospective study, SLN mapping followed by bilateral END of all mandibular LNs (MLNs) and medial retropharyngeal LNs (MRLNs) was performed in 39 dogs with spontaneously occurring oral neoplasia. A SLN was identified by ICTL in 38 (97%) dogs. Lymphatic drainage patterns were variable although most often the SLN was identified as a single ipsilateral MLN. In the 13 dogs (33%) with histopathologically confirmed LN metastasis, ICTL correctly identified the draining lymphocentrum in all (100%). Metastasis was confined to the SLN in 11 dogs (85%); 2 dogs (15%) had metastasis beyond the SLN ipsilaterally. Contrast enhanced CT features had good accuracy in predicting metastasis, with short axis measurements less than 10.5 mm most predictive. ICTL imaging features alone were unable to predict metastasis. Cytologic or histopathologic SLN sampling is recommended prior to treatment to inform clinical decision-making. This is the largest study to show potential clinical utility of minimally invasive ICTL for cervical LN evaluation in canine oral tumors.

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