Sentinel Nodes Are Identifiable in Formalin-Fixed Specimens After Surgeon-Performed Ex Vivo Sentinel Lymph Node Mapping in Colorectal Cancer

Smith, F. H.; Coffey, J. Calvin; Khasri, Nurul Mod; Walsh, Miriam; Parfrey, Nollaig A.; Gaffney, Eoin F.; Stephens, R. B.; Kennedy, M. John; Kirwan, W. O.; Redmond, H. P.

doi:10.1245/aso.2005.08.019

Cited by 15 publications

(15 citation statements)

References 27 publications

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“…Ex vivo sentinel node mapping was performed as described previously [32]. Briefly, within 10 min of resection, colorectal specimens were divided along their anti-mesenteric border with a scalpel, thereby exposing the tumor with approximately 4 cm of normal mucosa proximally and distally.…”

Section: Methodsmentioning

confidence: 99%

Nuclear beta-catenin overexpression in metastatic sentinel lymph node is associated with synchronous liver metastasis in colorectal cancer

et al. 2011

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BackgroundBeta-catenin, a component of the Wingless/Wnt signaling pathway, can activate target genes linking with the adenomatous polyposis coli (APC) gene in colorectal cancer. The purpose of this study is to investigate whether nuclear beta-catenin overexpression in metastatic sentinel lymph node(s) [SLN(s)] is associated with synchronous liver metastasis.MethodsClinicopathological data from 355 patients (93 cases with liver metastasis and 262 cases without liver metastasis) were reviewed. Beta-catenin expression in metastatic SLN(s) and liver metastatic lesions was examined by immunohistochemistry. The association of nuclear beta-catenin expression in metastatic SLN(s) and liver metastatic lesions was evaluated, and the relationship between nuclear beta-catenin expression and clinicopathological characteristics was analyzed. Finally, univariate and logistic multivariate regression analyses were adopted to discriminate the risk factors of liver metastasis.ResultsNuclear beta-catenin overexpression in metastatic SLN(s) was observed in 70 patients with liver metastasis and 31 patients without liver metastasis (75.3% vs. 11.8%; P < 0.001). Nuclear beta-catenin expression was noted in all the metastatic lesions. Spearman rank correlation analysis demonstrated that nuclear beta-catenin expression in metastatic SLN(s) had a positive correlation with that in metastatic lesions (r = 0.425, P < 0.001). Univariate and multivariate analyses indicated that nuclear beta-catenin overexpression in metastatic SLN(s) correlated with liver metastasis.ConclusionsNuclear beta-catenin overexpression in metastatic SLN(s) is strongly associated with liver metastasis and may contribute to predict liver metastasis.

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Section: Methodsmentioning

confidence: 99%

Nuclear beta-catenin overexpression in metastatic sentinel lymph node is associated with synchronous liver metastasis in colorectal cancer

et al. 2011

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“…An alternative means of detecting nodal metastases in rectal cancer is sentinel lymph node mapping (SLNM). This concept has been applied widely to colorectal cancer as a whole as a means of increasing the detection of nodal macrometastases and micrometastases both in vivo and ex vivo 83–85. SLNM has proved to be both a sensitive and specific means of identifying nodal metastases; however, it does not perform well after radiotherapy as lymphatic channels seem to be destroyed by inflammation and fibrosis84.…”

Section: Can Nodal Staging Be Enhanced For Rectal Conservation?mentioning

confidence: 99%

Rectum-conserving surgery in the era of chemoradiotherapy

Smith

Waldron

Winter

2010

British Journal of Surgery

136

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“…This procedure does not, however, fit easily into a routine clinical workflow. Identification after formalin fixation, as described by Faerden et al [21] and Smith et al [24], allows the procedure to be performed in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Ex vivo sentinel lymph node mapping in colorectal cancer using a magnetic nanoparticle tracer to improve staging accuracy: a pilot study

et al. 2016

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Aim: Nodal status is the most important prognostic factor in colorectal cancer (CRC).Small occult metastases may remain undetected on conventional histopathological examination, potentially resulting in undertreatment. Ex vivo sentinel lymph node mapping (SLNM) can be used to improve nodal staging accuracy, but currently used tracers suffer from drawbacks, which hampers implementation of the technique in routine clinical practice. Magnetic tracers have an optimal size for sentinel lymph node (SLN) retention and allow objective quantitative selection of SLNs and therefore have great potential for SLNM in CRC. The study evaluates the feasibility of ex vivo magnetic SLNM and compares the performance of this technique to blue dye SLNM.Method: Twenty-eight ex vivo SLNM procedures were performed in 27 histological node-negative patients with CRC using a magnetic tracer and blue dye. A magnetometer was used to select magnetic SLNs after formalin fixation of the CRC specimen. Both magnetic and blue SLNs were subjected to serial sectioning and immunohistochemical staining to reveal occult metastases.Results: At least one SLN was successfully identified in 27/28 (96%) and 25/28 (89%) of the cases with the magnetic technique and blue dye. Isolated tumour cells were detected in 10 patients. This was predicted with 100% sensitivity and accuracy using the magnetic technique, and with 91% sensitivity and 96% accuracy using the blue dye technique. Conclusion: This study demonstrates that ex vivo magnetic SLNM is a feasible techniquefor use in routine clinical practice, which improves nodal staging accuracy of CRC patients. Accepted ArticleThis article is protected by copyright. All rights reserved. What does this paper add to the literature?The study is the first to use a magnetic tracer and handheld magnetometer for SLNM in colorectal cancer. The procedure improves the accuracy of nodal staging by detecting small occult metastases, which potentially allows improved treatment. The ex-vivo procedure can easily be implemented in routine clinical practice.

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Sentinel Nodes Are Identifiable in Formalin-Fixed Specimens After Surgeon-Performed Ex Vivo Sentinel Lymph Node Mapping in Colorectal Cancer

Cited by 15 publications

References 27 publications

Nuclear beta-catenin overexpression in metastatic sentinel lymph node is associated with synchronous liver metastasis in colorectal cancer

Nuclear beta-catenin overexpression in metastatic sentinel lymph node is associated with synchronous liver metastasis in colorectal cancer

Rectum-conserving surgery in the era of chemoradiotherapy

Ex vivo sentinel lymph node mapping in colorectal cancer using a magnetic nanoparticle tracer to improve staging accuracy: a pilot study

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