Sentinel lymph node biopsy in esophageal cancer: an essential step towards individualized care

Abstract

Lymph node status is the most important prognostic factor in esophageal cancer. Through improved detection of lymph node metastases, using the sentinel lymph node concept, accurate staging and more tailored therapy may be achieved. This review article outlines two principle ways in which the sentinel lymph node concept could dramatically influence current standard of care for patients with esophageal cancer. We discuss three limitations to universal acceptance of the technique, and propose next steps for increasing enthusiasm amongst physicians and surgeons including the development of a universal tracer, and improved contrast agents with novel dual-modality 'visibility'.

Indocyanine-green-loaded microbubbles for localization of sentinel lymph node using near-infrared fluorescence/ultrasound imaging: a feasibility study

“…The term sentinel lymph node (SLN) refers to the rst regional lymph node or group of nodes to receive lymphatic drainage from a tumor. 1,2 Identication of SLN is a key criteria for tumor staging, the prognostic assessment, as well as for treatment planning. 3,4 Currently practiced dye-guided (visible blue dyes) and radio-guided techniques for SLN biopsy have high identi-cation rates; 5,6 however, both these methods have their limitations.…”

Laser irradiated fluorescent perfluorocarbon microparticles in 2-D and 3-D breast cancer cell models

“…This can be attributed, in part, to the low diffusivity and low solubility of PFH in water. Furthermore, the bubbles were comprised of a PLGA shell, which is more stable than the familiar microbubbles composed of lighter sulfur-hexafluoride (Sonovue) or perfluoropropane (Definity) gas 11 44 . Within the first 1 s of vaporization, the radial expansion ratio of our particle was almost 5x, which is close to the results reported for silica-coated lead sulfide nanoparticles loaded in PFC droplets vaporized via ODV (approximately 4.3 times the original droplet diameter) 9 and micron-sized lipid-encapsulated decafluorobutane droplets vaporized via ADV (approximately 5 to 6 times the original droplet diameter) 45 .…”

cT2N0 esophageal adenocarcinoma: predictors of lymph nodal involvement and clinical significance

“…A retrospective study by Mayo clinic on OLNMM as a predictor of lymph node relapse in nodenegative patients found no association between OLNMM and cancer relapse, and thus routine immunohistochemistry was not advocated in pN0 disease (18). Sentinel lymph node sampling is a novel concept in gastrointestinal cancers which theoretically may spare unnecessary lymph node dissection, while maintaining R0 resection and improving target lymph node yield, however, this concept is still in its nascent stages and needs further focused research (19).…”