How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer?

Sanidas, Elias; Bree, Eelco de; Tsiftsis, Dimitris D.

doi:10.1016/s0002-9610(02)01367-3

Cited by 76 publications

(45 citation statements)

References 69 publications

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“…All the 6 node-positive patients with negative GNs in both frozen and paraffin sections were encountered in the first 19 patients in each institution. Nowadays, it is well known that surgeon inexperience was associated with detection failure [15][16][17]. Unfortunately, we could not find the appropriate learning period in the present trial setting because of limited sample size resulting from termination midway through the trial.…”

Section: Discussionmentioning

confidence: 83%

High false-negative proportion of intraoperative histological examination as a serious problem for clinical application of sentinel node biopsy for early gastric cancer: final results of the Japan Clinical Oncology Group multicenter trial JCOG0302

et al. 2013

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Background To evaluate the feasibility and accuracy of diagnosis using sentinel node (SN) biopsy in T1 gastric cancer, a multicenter trial was conducted by the Japan Clinical Oncology Group (JCOG). Methods Sentinel node biopsy with indocyanine green (ICG) was performed in patients with T1 gastric cancer. Green-stained nodes (GNs), representing SNs, were removed first, and gastrectomy with lymphadenectomy was then performed. GNs in one plane (with the largest dimension) were histologically examined intraoperatively by frozen section with hematoxylin and eosin (H&E) stain. All harvested lymph nodes (GNs and non-GNs) were histologically examined by paraffin section after surgery. The primary endpoint was to determine the proportion of false negatives, which was defined as the number of patients with negative GNs by frozen section divided by those with positive GNs and/or positive non-GNs by paraffin section. The sample size was set at 1,550, based on the expected and threshold value as 5 and 10 % in the proportion of false negatives. Results Accrual was suspended when 440 patients were enrolled because the proportion of false negatives was high. In the primary analysis, the proportion of false negatives was 46 % (13/28) after a learning period with 5 patients for each institution. Seven of 13 patients had nodal metastases outside the lymphatic basin. False negatives remained at 14 % (4/28) even by examining additional sections of GNs by paraffin section. Conclusions The proportion of false negatives was much higher than expected. Intraoperative histological 123Gastric Cancer (2014( ) 17:316-323 DOI 10.1007 examination using only one plane is not an appropriate method for clinical application of SN biopsy in gastric cancer surgery.

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Section: Discussionmentioning

confidence: 83%

High false-negative proportion of intraoperative histological examination as a serious problem for clinical application of sentinel node biopsy for early gastric cancer: final results of the Japan Clinical Oncology Group multicenter trial JCOG0302

et al. 2013

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“…The dye-guided method is safe, convenient, and cost-effective, whereas the use of the radioactive probe-guided method in general hospitals is limited due to legal considerations and costs of radioactive substances [3,4]. However, the dye-guided method has certain limitations, such as loss of visibility in dense fat and the rapid transit of the dye, and thus adequate training is required [5][6][7]. These limitations are more critical in laparoscopic surgery.…”

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confidence: 99%

Laparoscopic detection of sentinel node in gastric cancer surgery by indocyanine green fluorescence imaging

et al. 2010

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“…In wie fern eine Lern kur ve beim Ope rateur die Falsch-ne ga tiv-Rate be ein flusst, muss bis heu te of fen blei ben, da sehr wider sprüch li che Da ten über den Ein fluss von Lern pha sen auf die Er folgs ra ten der Sen ti nellymph kno ten bi op sie vor lie gen [17,26,27]. Dies liegt u. a. er neut an der feh len den Stan dar di sie rung der Tech nik.…”

Section: An For De Run Gen An Den Ope Ra Teurunclassified

Qualitätsgesicherte Anwendung der Sentinellymphknotenbiopsie beim Mammakarzinom

2005

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How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer?

Cited by 76 publications

References 69 publications

High false-negative proportion of intraoperative histological examination as a serious problem for clinical application of sentinel node biopsy for early gastric cancer: final results of the Japan Clinical Oncology Group multicenter trial JCOG0302

High false-negative proportion of intraoperative histological examination as a serious problem for clinical application of sentinel node biopsy for early gastric cancer: final results of the Japan Clinical Oncology Group multicenter trial JCOG0302

Laparoscopic detection of sentinel node in gastric cancer surgery by indocyanine green fluorescence imaging

Qualitätsgesicherte Anwendung der Sentinellymphknotenbiopsie beim Mammakarzinom

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