Systematic Review of Sentinel Lymph Node Mapping Procedure in Colorectal Cancer

Zaag, Edwin S. van der; Bouma, Wim H.; Tanis, Pieter J.; Ubbink, Dirk T.; Bemelman, Willem A.; Buskens, Christianne J.

doi:10.1245/s10434-012-2417-0

Cited by 88 publications

(66 citation statements)

References 72 publications

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“…In fact, even if not yet completely established, CVL is crucial in micrometastatic clearance of central nodes, which are frequently missed by routine histological examination (27) and thus responsible for locoregional recurrence and systemic dissemination (24); furthermore, for cancers located in the hepatic flexure and proximal transverse colon, there is a metastatic nodes incidence of about 5% for subpyloric station and about 4% for right gastroepiploic arcade (28): thus, central transection of middle colic vessels, ligation of right gastroepiploic vessels at the origin, 10-15 cm of greater omentectomy off the tumor, and removal of subpyloric nodes are all mandatory, especially in advanced stages (8).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Complete Mesocolic Excision with Central Vascular Ligation in right colon cancer: long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery

Siani

Pulica

2014

Scand J Surg

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Aim: to analyze our experience in translating the concept of total mesorectal excision to "no-touch" complete removal of an intact mesocolonic envelope (complete mesocolic excision), along with central vascular ligation and apical node dissection, in the surgical treatment of right-sided colonic cancers, comparing "mesocolic" to less radical "nonmesocolic" planes of surgery in respect to quality of the surgical specimen and long-term oncologic outcome.Method: a total of 115 patients with right-sided colonic cancers were retrospectively enrolled from 2008 to 2013 and operated on following the intent of minimally invasive complete mesocolic excision with central vascular ligation.Results: morbidity and mortality were 22.6% and 1.7%, respectively. mesocolic, intramesocolic, and muscularis propria planes of resection were achieved in 65.2%, 21.7%, and 13% of cases, respectively, with significant impact for mesenteric plane of surgery on r0 resection rate (97.3%), circumferential resection margin <1 mm (2.6%), and consequent survival advantage (82.6% at 5 years) when compared to muscularis propria plane of surgery, with r0 resection rate and overall survival falling to 72% and 60%, respectively, and with circumferential resection margin <1 mm raising to 33.3%, all being statistically significant. stratifying patients for stage of disease, laparoscopic complete mesocolic excision with central vascular ligation significantly impacted survival in patients with stage ii, iiia/B, and in a subgroup of iiic patients with negative apical nodes.Conclusion: in our experience, minimally invasive complete mesocolic excision with central vascular ligation allows for both safety and higher quality of surgical specimens

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Complete Mesocolic Excision with Central Vascular Ligation in right colon cancer: long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery

Siani

Pulica

2014

Scand J Surg

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“…First, Prussian blue staining for iron detection was performed to verify the presence of the DIONs in cells. DIONs were added to high-sugar DMEM plus 10% FBS to 4 final concentrations of 0.5, 1.0, 1.5 and 2.0 mg/mL and coincubated with 5.0×10 5 LECs for 24 h as the DIONsLECs group, and then the DIONs-LECs were taken, and the culture medium was removed. They were rinsed with PBS to remove the extracellular free iron particles.…”

Section: In Vitro Coincubation Of Lecs and Dionsmentioning

confidence: 99%

“…2 For these reasons, correct intraoperative staging of metastatic LNs is essential for developing an individualized surgery. [3][4][5] Currently, the assessment of regional metastatic LNs is usually conducted via an imagological diagnosis, such as computed tomography (CT), magnetic resonance imaging (MRI) and 18F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET). These methods, especially FDG-PET, have exhibited usefulness in the diagnosis of primary tumors and regional metastatic LNs.…”

Section: Introductionmentioning

confidence: 99%

One-pot synthesis of dextran-coated iron oxide nanoclusters for real-time regional lymph node mapping

Fu¹,

Zhou²,

Wang³

et al. 2017

IJN

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The intraoperative precision cleaning of lymph nodes (LNs) is an essential component of treating neoplastic disease. To develop efficient probes for the targeted detection of LNs that could act as carriers for the specific diagnosis and treatment of metastatic LNs in the future, dextran-coated iron oxide nanoclusters (DIONs) were synthesized using a one-pot coprecipitation procedure. These modified DIONs have good water dispersibility, cytocompatibility, an optimum size, and a stable, dark brown color for LN imaging. In this study, cytotoxicity was evaluated using lymphatic endothelial cells (LECs) to predict biosafety and biocompatibility. Most importantly, the effectiveness of DIONs in mapping perigastric LNs in Sprague Dawley rats following injection into the gastric submucosal layer was demonstrated. In addition, a long-term tracing in vivo (from 4 days to 3 months) indicated that the DIONs had good biosafety and biocompatibility according to an evaluation of the behavior and blood biochemistry of the rat and a histopathological examination of the important organs.

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“…Radiocolloid technique is feasible [77], but labor intensive and not superior to the regular blue-dye technique currently used in most studies. In a recent systematic review [78], the pooled SLN identification rate was 90.7% (95% CI 88.2-93.3), with a significantly higher identification rate in studies including >100 patients or studies using the ex vivo SLN technique. The pooled sensitivity of the SLN procedure was 69.6% (95% CI 64.7-74.6), which increased to 80.2% (95% CI 4.7-10.7) when IHC findings were included.…”

Section: Resultsmentioning

confidence: 99%

Qualitative and Quantitative Issues of Lymph Nodes as Prognostic Factor in Colon Cancer

Veen¹,

Nedrebø²,

Stormark³

et al. 2013

Dig Surg

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For patients undergoing curative resections for colon cancer, the nodal status represents the strongest prognostic factor, yet at the same time the most disputed issue as well. Consequently, the qualitative and quantitative aspects of lymph node evaluation are thus being scrutinized beyond the blunt distinction between ‘node positive' (pN+) and ‘node negative' (pN0) disease. Controversy ranges from a minimal or ‘least-unit' strategy as exemplified by the ‘sentinel node' to a maximally invasive or ‘all inclusive' approach by extensive surgery. Ranging between these two extremes of node sampling strategies are factors of quantitative and qualitative value, which may be subject to modification. Qualitative issues may include aspects of lymph node harvest reflected by surgeon, pathologist and even hospital performance, which all may be subject to modification. However, patient's age, gender and genotype may be non-modifiable, yet influence node sample. Quantitative issues may reflect the balance between absolute numbers and models investigating the relationships of positive to negative nodes (lymph node ratio; log odds of positive lymph nodes). This review provides an updated overview of the current controversies and a state-of-the-art perspective on the qualitative and quantitative aspects of using lymph nodes as a prognostic marker in colon cancer.

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Systematic Review of Sentinel Lymph Node Mapping Procedure in Colorectal Cancer

Abstract: The SN procedure in colorectal cancer has an overall sensitivity of 70%, with increased sensitivity and refined staging in early-stage colon cancer. Because the ex vivo SN mapping is an easy technique it should be considered in addition to conventional resection in colon cancer.

Cited by 88 publications

References 72 publications

Laparoscopic Complete Mesocolic Excision with Central Vascular Ligation in right colon cancer: long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery

Laparoscopic Complete Mesocolic Excision with Central Vascular Ligation in right colon cancer: long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery

One-pot synthesis of dextran-coated iron oxide nanoclusters for real-time regional lymph node mapping

Qualitative and Quantitative Issues of Lymph Nodes as Prognostic Factor in Colon Cancer

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