Comparative Analysis of Nodal Upstaging Between Colon and Rectal Cancers by Sentinel Lymph Node Mapping: A Prospective Trial

Saha, Sukamal; Monson, Keith M.; Bilchik, Anton J.; Beutler, Thomas; Dan, Adrian G.; Schochet, Ellie; Wiese, David; Kaushal, Sunil; Ganatra, Balvant; Desai, D L

doi:10.1007/s10350-004-0661-5

Cited by 49 publications

(40 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies have suggested, without evidence of statistical significance, poorer SLNM results in colorectal cancer patients with large tumors and advanced disease (2,7) also in patients submitted to preoperative chemoradiotherapy (11) . But there is still necessity of defining precisely the optimal patient characteristics for performing SLNM in colorectal adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

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

Quadros¹,

Lopes

Araujo³

2010

Arq. Gastroenterol.

View full text Add to dashboard Cite

-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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Quadros¹,

Lopes

Araujo³

2010

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…It is particularly important since there is a possibility that patients initially diagnosed as clinical stage II (having no metastases to the lymph nodes) might be up-staged to stage III (those who have metastases present in the lymph nodes) and thus be qualified for adjuvant chemotherapy. Summary of the SLNB studies in CRC is presented in the Table 4 [7,20,21,[26][27][28][29][30][31][32][33].…”

Section: Legend: Ptnm -Pathological Classification Of Malignant Tumoumentioning

confidence: 99%

“…Such high-quality results were attributable to added method of micro sections and IHC staining. In the reported group, 19% of patients in view of SLNB were up-graded from stage II to stage III [7,30].…”

Section: Legend: Ptnm -Pathological Classification Of Malignant Tumoumentioning

confidence: 99%

“…Consequently, at present SLNB method is perceived to be of limited practical significance, especially for rectal cancer patients [19]. Worse results achieved in the sub-group of rectal cancer patients are justified by the difficulties in identification of a stained lymph node in the mesorectum and distinctive anatomical structure of the rectum [6,30].…”

Section: Legend: Ptnm -Pathological Classification Of Malignant Tumoumentioning

confidence: 99%

“…The possibility to detect aberrant lymphatic drainage [ALD] is an additional advantage of SLNB. ALD is described in as much as 14% of cases and its presence may be an indication for extension of the surgical field and resection of additional lymph nodes [16,30]. ALD was reported for the tumors located in the right colon [5].…”

Section: Legend: Ptnm -Pathological Classification Of Malignant Tumoumentioning

confidence: 99%

See 2 more Smart Citations

Sentinel lymph node in colorectal cancer — 5 years follow up

et al. 2011

View full text Add to dashboard Cite

AbstractTo assess the impact of micrometastases in sentinel and non-sentinel lymph nodes on long-term survival rates of patients treated for colorectal cancer (CRC). Data of 57 patients diagnosed with CRC and treated in the Department of Surgical Oncology in Gdansk in the years 2002–2006 were retrospectively analyzed. Clinico-histopathological data were analyzed using chi-square tests. The effect on long-time survival rates was analyzed using Kaplan-Meier survival probability estimates. Identification of the SLN was performed using the blue dye staining method. All regional lymph nodes were subject to standard histopathological examination. Additionally in 32(56.14%) patients whose nodes were found negative for metastases on standard staining further immunohistochemical analyses were performed. In the analyzed group SLNB was performed in 42(73.7%) patients with colon cancer and in 15(26.3%) with rectal cancer. Identification of the SLN was possible in 45(78.9%) patients. The sensitivity of SLNB was 33%. False negatives were found in 66%. SLNB is a feasible method in CRC patients. We presume that lack of micrometastases in the SLN and non-SLN cannot be regarded as a prognostic factor.

show abstract

Sentinel node detection after preoperative short-course radiotherapy in rectal carcinoma is not reliable

Braat

Oosterhuis

Moll

et al. 2005

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

Comparative Analysis of Nodal Upstaging Between Colon and Rectal Cancers by Sentinel Lymph Node Mapping: A Prospective Trial

Abstract: Despite higher success rates in sentinel lymph node identification for colon patients, sentinel lymph node mapping was highly successful (91.5 percent) in rectal patients. Nodal upstaging, skip metastases, and occult metastases were similar.

Cited by 49 publications

References 20 publications

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

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

Sentinel lymph node in colorectal cancer — 5 years follow up

Sentinel node detection after preoperative short-course radiotherapy in rectal carcinoma is not reliable

Contact Info

Product

Resources

About