Upstaging benefits and accuracy of sentinel lymph node mapping in colorectal adenocarcinoma nodal staging

Quadros, Claudio Almeida; Lopes, Ademar; Araujo, Iguaracyra; Fregnani, José Humberto Tavares Guerreiro; Fahel, Fernanda

doi:10.1002/jso.21112

Cited by 28 publications

(29 citation statements)

References 34 publications

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“…SLNM using technetium-99m-phytate and patent blue was performed prospectively in 52 consecutive colorectal adenocarcinoma patients during their standard curative surgery, from January 2004 to July 2005 (10) . All surgical procedures and pathologic examinations were performed respectively by the first and third authors, at a single institution, the Aristides Maltez Hospital, Salvador, BA, Brazil.…”

Section: Methodsmentioning

confidence: 99%

“…The neoadjuvant chemoradiotherapy protocol, SLNM procedure, and the special methods for enhanced pathologic analysis including step-sectioning and immunohistochemistry were described in a previous publication (10) . The definition of micrometastasis was nodal tumor measured less than 0.2 cm in the larger diameter or only detectable by immunohistochemistry.…”

Section: Methodsmentioning

confidence: 99%

“…The lower rectum was considered the lower 1/3 including the anal canal. The midrectum was the intermediate 1/3 rectal segment between the upper and lower rectum (10) .…”

Section: Methodsmentioning

confidence: 99%

“…Performing SLNM during standard colorectal surgery provides the retrieval of a small number of sentinel lymph nodes that represent the entire surgical specimens' lymph node status. A more detailed pathologic examination of the sentinel lymph nodes results in the detection of lymph node metastases that otherwise would go undetected, improving nodal staging (10) .…”

Section: Introductionmentioning

confidence: 99%

“…The study's multivariate statistical analysis considered lower rectal tumor site, preoperative chemoradiotherapy (neoadjuvant treatment) and large tumors as independent risk factors for the inability of sentinel lymph node identification (10) .…”

Section: Introductionmentioning

confidence: 99%

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Suggestion of optimal patient characteristics for sentinel lymph node mapping in colorectal adenocarcinoma

Quadros¹,

Lopes

Araujo³

2010

Arq. Gastroenterol.

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-Context -In a previously published study, the variables lower rectal tumor site, preoperative chemoradiotherapy and large tumors were considered as independent risk factors for the inability of sentinel lymph node identification in patients with colorectal adenocarcinoma. Objectives -To determine if these variables could interfere in the precision and upstaging benefit of sentinel lymph node mapping in colorectal cancer. Methods -A database composed of 52 patients submitted to lymphatic mapping using technetium-99m-phytate and patent blue was reviewed. Only patients with tumors smaller than 5.0 cm, not submitted to preoperative chemoradiotherapy and without lower rectal cancer were included. Results -With these parameters, 11 patients remained to be studied. The sentinel lymph node identification rate was 100%, with a sensitivity of 100%, negative predictive value of 100%, no false negatives and accuracy of 100%. Sentinel lymph nodes were the only metastatic nodes in 36.4% of the patients, micrometastases (<0.2 cm or only identified by immunohistochemistry) provided an upstaging rate of 27.1% and metastases an upstaging rate of 9.1%. Conclusion -The parameters proposed in this study for selection of colorectal adenocarcinoma patients to be submitted to sentinel lymph node mapping identified optimal accuracy and good upstaging results. As the number of included patients was low, these results could serve as guidance for proper patient selection in further prospective lymph node mapping studies in colorectal cancer patients. HEADINGS -Colorectal neoplasms. Adenocarcinoma. Neoplasm staging. Sentinel lymph node biopsy.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The lower rectum was considered the lower 1/3 including the anal canal. The midrectum was the intermediate 1/3 rectal segment between the upper and lower rectum (10) .…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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