Technical Details of Sentinel Lymph Node Mapping in Colorectal Cancer and Its Impact on Staging

Saha, Sukamal; Wiese, David; Badin, Julio; Beutler, Thomas; Nora, Dean T.; Ganatra, Bela; Desai, D L; Kaushal, Sunil; Nagaraju, Marigowda; Arora, Madan L.; Singh, T.

doi:10.1007/s10434-000-0120-z

Cited by 224 publications

(163 citation statements)

References 9 publications

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“…Initial studies reported encouraging results, with a 98% SLN identification rate and a 96% accuracy rate for SLNs as an indicator of the regional lymph node status. [13][14][15] We have been unable to duplicate those initial results. In our previous study, we reported an FN rate of 38%.…”

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of radiocolloid and immunohistochemical staining in colon carcinoma lymphatic mapping

Patten

Berger

Rodrı́guez-Bigas

et al. 2004

Cancer

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BACKGROUNDAlthough the utility of lymphatic mapping (LM) and sentinel lymph node (SLN) biopsy in patients with melanoma and breast carcinoma has been well documented, this same is not true for patients with colon carcinoma. The authors previously reported a high false‐negative rate for SLN biopsy in patients with colon carcinoma using isosulfan blue dye alone. The objective of the current study was to determine whether radiocolloid would increase the sensitivity of LM/SLN biopsy in patients with colon carcinoma.METHODSThe authors performed LM on 57 patients with colon carcinoma using both isosulfan blue dye and radiocolloid. The SLN(s) were identified by either their blue color or by increased radioactivity. The SLNs then underwent both routine histologic sectioning and immunohistochemical (IHC) staining for cytokeratins.RESULTSAn SLN was identified in 56 patients (98%). Radiocolloid was able to identify only 1 additional positive SLN (9%). Overall, it was found that the disease had metastasized to the lymph nodes in 22 patients, even though there was no evidence of disease in the SLN(s) in 11 of those 22 patients on routine histologic sectioning (false‐negative rate, 50%; sensitivity, 50%). In five patients, IHC of the SLN was the only indicator of metastatic disease. The inclusion of IHC‐positive SLNs in these calculations would decrease the false‐negative rate to 17% and would increase the sensitivity of SLN biopsy to 83%.CONCLUSIONSIn the current study, the addition of radiocolloid did not increase the sensitivity of detection of positive SLN(s) compared with the use of isosulfan blue dye alone. IHC of the SLN potentially may increase the sensitivity of LM and reduce the false‐negative rate. However, the long‐term prognostic significance of IHC in patients with colon carcinoma remains controversial. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

A prospective evaluation of radiocolloid and immunohistochemical staining in colon carcinoma lymphatic mapping

Patten

Berger

Rodrı́guez-Bigas

et al. 2004

Cancer

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“…Lymph node dissection areas can be accurately assessed by SNNS in patients with breast cancer and malignant melanoma (Veronesi et al, 1997;Edwards et al, 1998). The SN concept has recently been applied to gastrointestinal tract cancers including gastric cancers (Saha et al, 2000;Aikou et al, 2001;Uenosono et al, 2003), but its clinical application remains controversial. An assured diagnosis of lymph node micrometastasis determined by RT -PCR is essential when performing SNNS, since the clinical significance of lymph node micrometastasis is also contentious (Ishida et al, 1997).…”

Section: Lymphatic Invasion and Micrometastasis In Gastric Cancer T Amentioning

confidence: 99%

“…The key causative factor of recurrent gastric cancer is lymph node micrometastasis. The sentinel node (SN) concept has recently been applied to gastrointestinal tract cancers including gastric cancer (Saha et al, 2000;Aikou et al, 2001;Uenosono et al, 2003). During sentinel node navigation surgery (SNNS), lymph node micrometastasis cannot be disregarded.…”

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confidence: 99%

Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer

et al. 2005

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The monoclonal antibody D2-40 is a specific lymphatic endothelial markers and D2-40 staining have been applicable to evaluate lymphatic invasion in various malignant neoplasms. In the present study, we investigated lymph node micrometastasis determined by immunohistochemistry (IHC) and reverse transcription -polymerase chain reaction (RT -PCR) in all dissected lymph nodes obtained from 80 patients with node-negative gastric cancer, and analysed the relationship between micrometastasis and clinicopathological findings including lymphatic invasion of the resected primary tumour using D2-40 immunohistochemical staining. The incidence of micrometastasis determined by IHC and RT -PCR was 11.3% (nine out of 80) and 31.3% (25 out of 80), respectively. Although haematoxylin -eosin (HE) staining revealed lymphatic invasion in 11.3% (nine out of 80) of patients, D2-40 staining uncovered new invasion in 23.8% (19 out of 80) of patients. In the diagnosis of HE and D2-40 staining, the incidence of micrometastasis was significantly higher in patients with lymphatic invasion than in those without lymphatic invasion (P ¼ 0.0150 and Po0.0001, respectively). Micrometastasis correlated more closely with D2-40 than with HE staining. We demonstrated a high incidence of micrometastasis and lymphatic invasion and a correlation between them even in pN0 gastric cancer. When planning less invasive treatment, the presence of such occult cancer cells should be considered.

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“…Many reports of SLN biopsy in CRC are emerging [60][61][62][63][64][65][66][67][68]. These studies vary from small single-institution reviews to prospective multi-institutional studies.…”

Section: Colonmentioning

confidence: 99%

Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies

2003

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Lymphatic mapping and sentinel lymph node biopsy were first reported in 1977 by Cabanas for penile cancer. Since that time, the technique has become rapidly assimilated into clinical practice. Morton first described the application of lymphatic mapping for melanoma only a decade ago, and this technique is now accepted as the standard of care. The application for lymphatic mapping and sentinel lymph node biopsy in breast cancer remains approximately 5 years behind its utilization in melanoma.This technique has the potential to be utilized in all solid tumors. The rapid assent of this technique in clinical practice is the result of multiple factors, including accuracy, decreased morbidity, and supplying the pathologist with only a few nodes to allow a more focused and sensitive pathologic evaluation. Despite the success and acceptance of lymphatic mapping, many controversies remain. We have attempted to clearly highlight these controversies in this review.

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Technical Details of Sentinel Lymph Node Mapping in Colorectal Cancer and Its Impact on Staging

Cited by 224 publications

References 9 publications

A prospective evaluation of radiocolloid and immunohistochemical staining in colon carcinoma lymphatic mapping

A prospective evaluation of radiocolloid and immunohistochemical staining in colon carcinoma lymphatic mapping

Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer

Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies

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