Magnetic Marking and Intraoperative Detection of Primary Draining Lymph Nodes in High-Risk Prostate Cancer Using Superparamagnetic Iron Oxide Nanoparticles: Additional Diagnostic Value?

Winter, Alexander; Engels, Svenja; Reinhardt, Lena; Wasylow, Clara; Gerullis, Holger; Wawroschek, Friedhelm

doi:10.20944/preprints201711.0043.v1

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…The staging of pelvic LN in PCa allows a statement with regards to prognosis and treatment options and therefore LN dissection in PCa is recommended for intermediate and high-risk patients (21). Lymphatic drainage from the prostate has high individual variability, and direct drainage outside the pelvic area is observed rarely (17,22).…”

Section: Discussionmentioning

confidence: 99%

"Influence of lymph node degeneration on metastases in prostate cancer - or why we must look for a needle in a haystack"

Gödde

Degener

Walles

et al. 2022

Preprint

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BackgroundTo evaluate the incidence of lymph node degeneration and its association with nodal metastatic pattern in prostate cancer. MethodsA retrospective analysis of the submitted lymph node specimen of 390 prostatectomies in 2011 was performed. All lymph nodes were histologically re-evaluated and the degree of lymph node degeneration e.g. lipomatous atrophy, capsular and framework fibrosis, and calcifications as well as the lymph node size were recorded. Lymph node degeneration was compared in the anatomic regions of the pelvis as well as in lymph nodes with and without metastases of prostatic cancer.Results81 of 6026 lymph nodes demonstrated metastases and a complete histological examination of 5173 lymph nodes was feasible. The incidence of lymph node degeneration was different across the various landing sites. Lymph node metastases were primarily detected in less degenerative and therefore more functional lymph nodes. In metastatic vs. non-metastatic lymph nodes low lipomatous atrophy was reported in 84,0% vs. 66,7% (p=0,004), capsular fibrosis in 14,8% vs. 35,4% (p < 0.001), calcifications in 35,8% vs.46,1% (p=0,072) and framework fibrosis in 69,8% vs. 75,3% (p=0,53). Metastases were also identified more frequently in larger than in smaller lymph nodes (63,0% vs. 47,5%; p=0,007).ConclusionsDegenerative changes in pelvic lymph nodes are commonly detectable but occur with variable frequency in the various nodal landing sites in the pelvis. The degree of lymph node degeneration of single lymph nodes has a significant influence on whether a lymph node is infiltrated by tumor cells and may harbour metastases.

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Section: Discussionmentioning

confidence: 99%

"Influence of lymph node degeneration on metastases in prostate cancer - or why we must look for a needle in a haystack"

Gödde

Degener

Walles

et al. 2022

Preprint

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Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking

Engels

Michalik

Meyer

et al. 2021

Cancers

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Sentinel pelvic lymph node dissection (sPLND) enables the targeted removal of lymph nodes (LNs) bearing the highest metastasis risk. In prostate cancer (PCa), sPLND alone or combined with extended PLND (ePLND) reveals more LN metastases along with detecting sentinel LNs (SLNs) outside the conventional ePLND template. To overcome the disadvantages of radioisotope-guided sPLND in PCa treatment, magnetometer-guided sPLND applying superparamagnetic iron oxide nanoparticles as a tracer was established. This retrospective study compared the nodal staging ability between magnetometer- and radioisotope-guided sPLNDs. We analyzed data of PCa patients undergoing radical prostatectomy and magnetometer- (848 patients, 2015–2021) or radioisotope-guided (2092 patients, 2006–2015) sPLND. To reduce heterogeneity among cohorts, we performed propensity score matching and compared data considering sentinel nomogram-based probabilities for LN involvement (LNI). Magnetometer- and radioisotope-guided sPLNDs had SLN detection rates of 98.12% and 98.09%, respectively; the former detected more SLNs per patient. The LNI rates matched nomogram-based predictions in both techniques equally well. Approximately 7% of LN metastases were detected outside the conventional ePLND template. Thus, we confirmed the reliability of magnetometer-guided sPLND in nodal staging, with results comparable with or better than radioisotope-guided sPLND. Our findings highlight the importance of the sentinel technique for detecting LN metastases in PCa.

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Sentinel Lymph Node Techniques in Urologic Oncology: Current Knowledge and Application

Małkiewicz

Kiełb

Kobylański

et al. 2023

Cancers

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Lymph node (LN) metastases have a significant negative impact on the prognosis of urological malignancies. Unfortunately, current imaging modalities are insufficient when it comes to detecting micrometastases; thus, surgical LN removal is commonly used. However, there is still no established ideal lymph node dissection (LND) template, leading to unnecessary invasive staging and the possibility of missing LN metastases located outside the standard template. To address this issue, the sentinel lymph node (SLN) concept has been proposed. This technique involves identifying and removing the first group of draining LNs, which can accurately stage cancer. While successful in breast cancer and melanoma, the SLN technique in urologic oncology is still considered experimental due to high false-negative rates and lack of data in prostate, bladder, and kidney cancer. Nevertheless, the development of new tracers, imaging modalities, and surgical techniques may improve the potential of the SLN procedures in urological oncology. In this review, we aim to discuss the current knowledge and future contributions of the SLN procedure in the management of urological malignancies.

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Magnetic Marking and Intraoperative Detection of Primary Draining Lymph Nodes in High-Risk Prostate Cancer Using Superparamagnetic Iron Oxide Nanoparticles: Additional Diagnostic Value?

Cited by 3 publications

References 16 publications

"Influence of lymph node degeneration on metastases in prostate cancer - or why we must look for a needle in a haystack"

"Influence of lymph node degeneration on metastases in prostate cancer - or why we must look for a needle in a haystack"

Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking

Sentinel Lymph Node Techniques in Urologic Oncology: Current Knowledge and Application

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