Sentinel Node Procedure in Prostate Cancer: A Systematic Review to Assess Diagnostic Accuracy

Wit, Esther; Acar, Cenk; Grivas, Nikolaos; Yuan, Cathy; Horenblas, Simon; Liedberg, Fredrik; Olmos, Renato A. Valdés; Leeuwen, Fijs W. B. van; Berg, Nynke S. van den; Winter, Alexander; Wawroschek, Friedhelm; Hruby, Stephan; Janetschek, Günter; Vidal-Sicart, Sergi; MacLennan, Steven; Lam, Thomas; Poel, Henk G. van der

doi:10.1016/j.eururo.2016.09.007

Cited by 108 publications

(110 citation statements)

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“…Therefore, patients with high risk of nodal involvement should undergo an extended PLND, based on a template including common iliac arteries up to the cross with ureter obturator region and LNs medial and lateral of the internal iliac vessels. As suggested by the authors, SNB in combination with ePLND seems to provide a better nodal removal by increasing the number of affected nodes in 5% of cases in high risk PCa (9).…”

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confidence: 76%

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Sentinel node biopsy in combination with extended pelvic lymph node dissection for men with prostate cancer at risk of nodal involvement

Gacci¹,

Spatafora²,

Serni³

2016

Translational Cancer Research

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mentioning

confidence: 76%

“…In (9). The authors have identified more than 300 articles and selected 21 studies identified from January 1, 1999 to May 31, 2016, recruiting a total of 2,509 patients.…”

mentioning

confidence: 99%

Sentinel node biopsy in combination with extended pelvic lymph node dissection for men with prostate cancer at risk of nodal involvement

Gacci¹,

Spatafora²,

Serni³

2016

Translational Cancer Research

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“…One meta-analysis demonstrated a pooled detection rate of 93.8% for the radio-guided sentinel approach [17]. A systematic literature review considering 21 studies recruiting 2509 patients, found a median cumulative percentage detection rate of 95.9% (IQR 89.4-98.5%) [4]. However, in the SentiMag Pro II study, we adjusted the exclusion criteria according to some of the fundamental limitations of sLND already described by us and others (e.g., previous hormonal treatment or prostate surgery), which may have improved our detection rate [13].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic accuracy of this radioactive sentinel LN dissection (sLND) approach was determined in a systematic literature review. Twenty-one studies including 2509 patients were analyzed [4]. The findings demonstrated that the diagnostic reliability of eLND and sLND were almost comparable.…”

Section: Introductionmentioning

confidence: 96%

Accuracy of Magnetometer-Guided Sentinel Lymphadenectomy after Intraprostatic Injection of Superparamagnetic Iron Oxide Nanoparticles in Prostate Cancer: The SentiMag Pro II Study

Winter

Engels

Goos

et al. 2019

Cancers

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Radioisotope-guided sentinel lymph node dissection (sLND) has shown high diagnostic reliability in prostate (PCa) and other cancers. To overcome the limitations of the radioactive tracers, magnetometer-guided sLND using superparamagnetic iron oxide nanoparticles (SPIONs) has been successfully used in PCa. This prospective study (SentiMag Pro II, DRKS00007671) determined the diagnostic accuracy of magnetometer-guided sLND in intermediate-and high-risk PCa. Fifty intermediate-or high-risk PCa patients (prostate-specific antigen (PSA) ≥ 10 ng/mL and/or Gleason score ≥ 7; median PSA 10.8 ng/mL, IQR 7.4-19.2 ng/mL) were enrolled. After the intraprostatic SPIONs injection a day earlier, patients underwent magnetometer-guided sLND and extended lymph node dissection (eLND, followed by radical prostatectomy. SLNs were detected in in vivo and in ex vivo samples. Diagnostic accuracy of sLND was assessed using eLND as the reference. SLNs were detected in all patients (detection rate 100%), with 447 sentinel lymph nodes SLNs (median 9, IQR 6-12) being identified and 966 LNs (median 18, IQR 15-23) being removed. Thirty-six percent (18/50) of patients had LN metastases (median 2, IQR 1-3). Magnetometer-guided sLND had 100% sensitivity, 97.0% specificity, 94.4% positive predictive value, 100% negative predictive value, 0.0% false negative rate, and 3.0% additional diagnostic value (LN metastases only in SLNs outside the eLND template). In vivo, one positive SLN/LN-positive patient was missed, resulting in a sensitivity of 94.4%. In conclusion, this new magnetic sentinel procedure has high accuracy for nodal staging in intermediate-and high-risk PCa. The reliability of intraoperative SLN detection using this magnetometer system requires verification in further multicentric studies.

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“…An enabling technology is the ability to remove lymph nodes with exquisite accuracy and in a minimally invasive manner. In human cancer patients, resection of only the first tumor-draining nodes has become standard of care for breast cancer and an expanding list of tumor types [15–17]. The technology involves injection of radioactive colloid around the target tissue which is then carried through the lymphatic vessels to lymph nodes [18].…”

Section: Discussionmentioning

confidence: 99%

Vaccine-draining lymph nodes of cancer patients for generating anti-cancer antibodies

et al. 2017

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BackgroundOur research is focused on using the vaccine draining lymph node to better understand the immune response to cancer vaccines and as a possible source of anti-cancer reagents. We evaluated vaccine draining lymph nodes archived from a clinical study in melanoma patients and determined the reaction of B cells to the vaccine peptides.MethodsMononuclear cells (MNCs) were recovered from cryopreserved lymph nodes that were directly receiving drainage from multi-peptide melanoma vaccine. The patients were enrolled on a vaccine study (NCT00089219, FDA, BB-IND No. 10825). B cell responses in the vaccine-draining lymph nodes were studied under both stimulated and un-stimulated conditions. Cryopreserved cells were stimulated with CD40L, stained with multiple human cell-surface markers (CD19, CD27, IgM) to identify different categories of B cell sub populations with flow cytometry. Hybridomas were generated from the lymph node cells after CD40L-stimulation. Cells were fused to murine plasmacytoma P3X63.Ag8.653 using Helix electrofusion chamber. ELISA was used to evaluate hybridoma derived antibody binding to vaccine peptides.ResultsViable MNCs were satisfactorily recovered from lymph nodes cryopreserved from six vaccine study patients 8–14 years previously. B cell ELISPOT demonstrated responses for each patient to multiple vaccine peptides. CD40L stimulation of lymph node cells increased the proportion of CD19+ CD27+ cells from 12 to 65% of the sample and increased the proportion of class-switched cells. Screening of IgG secreting clones demonstrated binding to melanoma vaccine peptides.ConclusionsB cells were successfully recovered and expanded from human cryopreserved vaccine-draining lymph nodes. Individual B cells were identified that secreted antibodies that bound to cancer vaccine peptides. The ability to reliably generate in vitro the same antibodies observed in the blood of vaccinated patients will facilitate research to understand mechanisms of human antibody activity and possibly lead to therapeutic antibodies.

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Sentinel Node Procedure in Prostate Cancer: A Systematic Review to Assess Diagnostic Accuracy

Abstract: This literature review showed a high diagnostic accuracy for sentinel node biopsy in detecting positive lymph nodes in prostate cancer, but further studies are needed to explore the effect of sentinel node biopsy on complications and oncologic outcome.

Cited by 108 publications

References 43 publications

Sentinel node biopsy in combination with extended pelvic lymph node dissection for men with prostate cancer at risk of nodal involvement

Sentinel node biopsy in combination with extended pelvic lymph node dissection for men with prostate cancer at risk of nodal involvement

Accuracy of Magnetometer-Guided Sentinel Lymphadenectomy after Intraprostatic Injection of Superparamagnetic Iron Oxide Nanoparticles in Prostate Cancer: The SentiMag Pro II Study

Vaccine-draining lymph nodes of cancer patients for generating anti-cancer antibodies

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