Intraoperative Radiolymphoscintigraphy Improves Sentinel Lymph Node Identification for Patients with Melanoma

Albertini, John J.; Cruse, C. Wayne; Rapaport, D; Wells, Karen; Ross, Merrick I.; DeConti, Ronald C.; Berman, Claudia G.; Jared, Karen; Messina, Jane L.; Lyman, Gary H.; Glass, Frank; Fenske, Neil A.; Reintgen, Douglas S.

doi:10.1097/00000658-199602000-00016

Cited by 481 publications

(238 citation statements)

References 15 publications

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“…Sentinel lymph nodes free of tumor have a high degree of accuracy in predicting a negative regional lymph node basin. [55][56][57][58][59] SLNB may have a role in staging the clinically negative neck in patients with SCCOT. A recent international conference on SLNB in mucosal head and neck carcinoma, including all head and neck subsites, combined results from 22 centers.…”

Section: Discussionmentioning

confidence: 99%

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Greenberg

Naggar

et al. 2003

Cancer

167

116

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At present, storage capacities of single tank and tank farm have been greatly increasing. This change poses a real challenge for the applicability of current design standards. This article focuses on the applicability of safety spacing between tanks, which is one of the most important parameters of tank farm safety design. Taking PHAST and FDS as main research tools, the consequences of representative accidental scenarios were evaluated for different sizes of oil tanks to study the safety performance change caused by the increase of capability. The research results show that, when current standards are used to design the safety spacing between tanks, the safety performance increases as the capability increases. Considering the high property density, it is suggested that a higher safety performance objective has to be chosen when designing the safety spacing for ultra‐large oil tanks. © 2012 American Institute of Chemical Engineers Process Saf Prog, 2012.

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Section: Discussionmentioning

confidence: 99%

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Greenberg

Naggar

et al. 2003

Cancer

167

116

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“…18 On the day before the surgery (but at least four hours before the surgery), human colloidal albumin was administered with isotope (99mTc) tracing under ultrasound or X-ray guidance near the lesion. A lymphoscintigraphic (static) examination was then performed to determine the projection of SLN(s) and lymphatic drainage.…”

Section: Methodsmentioning

confidence: 99%

Is intraoperative touch imprint cytology indicated in the surgical treatment of early breast cancers?

Horváth

Paszt

Simonka

et al. 2017

European Journal of Surgical Oncology (EJSO)

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Introduction: Intraoperative touch imprint cytology (TIC) of the sentinel lymph node(s) (SLN(s)) in the treatment of breast cancer has significantly reduced the number of axillary block dissections (ABD) required during second surgeries. Based on recent studies, ABD was not considered necessary if the presence of tumor cells/micrometastasis was confirmed in the SLN(s) or in the case of macrometastases in a patient group meeting the inclusion criteria for the ACOSOG Z0011 study. Our aim was to determine the sensitivity and usefulness of TIC with regard to these results. Methods: TICs of the SLN(s) were examined in 1168 patients operated on for breast cancer. The method was also analyzed retrospectively based on the guidelines for the Z0011 study. During TIC, new samples were cut every 250 mm; impression smears were evaluated after being stained with hematoxylin eosin. Results: TIC confirmed metastasis in 202 cases (202/1168, 17.29%). Metastasis was confirmed in SLN(s) in 149 additional cases during a final histological examination. The sensitivity of TIC was found to be 57.18%, and its specificity was 99.63%. An analysis was then performed except for cases that met the inclusion criteria for the Z0011 study and with metastasis smaller than 2 mm (micrometastasis/isolated tumor cells) considered to be positive during intraoperative cytology. The sensitivity of the method decreased to 34.23%, while its specificity was still high at 99.76%. Conclusions: Based on the new guidelines for ABD, imprint cytology cannot be considered a beneficial and cost-effective intervention in the surgical treatment of early breast cancer.

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“…When histologically positive SLNs are found, they are usually, but not always, the hottest nodes. Several operational definitions of the SLN have evolved over time to help the surgeon decide exactly which nodes should be removed to maximize the likelihood of locating the true biologic SLN and minimize the superfluous removal of multiple nonSLNs (30)(31)(32)(33)(34)(35). An operational SLN definition that was associated with the lowest false-negative rate, using the extensive database of the Sunbelt Melanoma Trial, was described as ''.…”

Section: Discussionmentioning

confidence: 99%

Optimal Detection of Sentinel Lymph Node Metastases by Intraoperative Radioactive Threshold and Molecular Analysis in Patients with Melanoma

Manca¹,

Romanini²,

Pellegrino³

et al. 2008

J Nucl Med

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The aim of this study was to optimize a protocol for radioguided biopsy of the sentinel lymph node (SLN) in patients with melanoma. The protocol was based on a combination of ex vivo counting of the nodes detected intraoperatively and analysis of the harvested nodes by hematoxylin and eosin staining plus immunohistochemistry (conventional histopathology [PATH]) and by molecular biology (reverse-transcriptase polymerase chain reaction [RT-PCR]). Methods: A total of 124 patients with primary clinical stage I-II (according to the American Joint Committee on Cancer) cutaneous melanoma underwent successful radioguided SLN biopsy. SLNs harvested for analysis included any additional nodes whose ex vivo counting rate exceeded 20% of the hottest node. All removed SLNs were examined by conventional PATH and with RT-PCR analysis for the expression of messenger RNA for tyrosinase and the melanoma antigens recognized by T cells. Complete lymph node dissection (CLND) was performed only in the case of SLN metastasis detected by PATH. Different combinations of the intraoperative parameters (only the hottest node and all nodes harvested) and of analysis (PATH and RT-PCR) were tested as predictors of clinical outcome on the basis of long-term follow-up (12-81 mo; median, 55 mo). Results: A total of 197 SLNs were harvested, 41 of which harbored metastasis as detected by RT-PCR analysis; PATH detected metastasis in only 24 of 41 metastatic SLNs. In 5 of 41 instances, metastasis was not in the hottest SLN. The main factor determining correct classification of the SLN status was RT-PCR, which significantly improved detection of metastasis, even if applied only to the hottest node (P , 0.0001 vs. PATH analysis of either the hottest SLN or all nodes above the 20% threshold). Metastatic disease recurred locally in 5 patients who had not undergone CLND; RT-PCR analysis showed metastasis in 4 of these patients. The false-negative rate of SLN biopsy progressively decreased when applying PATH only to the hottest node (32.1%), additional RT-PCR to the hottest node (21.4%), PATH to all nodes (17.9%), and RT-PCR to all nodes (3.6%, P 5 0.015 vs. PATH analysis of only the hottest SLN). Conclusion: On the basis of long-term follow-up (the gold standard for final clinical outcome of SLN biopsy), both 20% threshold and RT-PCR analysis should be applied for optimal detection of nodal metastases in patients with melanoma.

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Intraoperative Radiolymphoscintigraphy Improves Sentinel Lymph Node Identification for Patients with Melanoma

Abstract: The use of intraoperative radiolymphoscintigraphy can improve the identification of all SLNs during selective lymphadenectomy.

Cited by 481 publications

References 15 publications

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Is intraoperative touch imprint cytology indicated in the surgical treatment of early breast cancers?

Optimal Detection of Sentinel Lymph Node Metastases by Intraoperative Radioactive Threshold and Molecular Analysis in Patients with Melanoma

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