Detection of metastatic disease with sentinel lymph node dissection in colorectal carcinoma patients.

Details

Serval ID
serval:BIB_A01463FD3693
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Detection of metastatic disease with sentinel lymph node dissection in colorectal carcinoma patients.
Journal
European Journal of Surgical Oncology
Author(s)
Matter M., Winckler M., Aellen S., Bouzourene H.
ISSN
1532-2157[electronic]
Publication state
Published
Issued date
2007
Volume
33
Number
10
Pages
1183-1190
Language
english
Abstract
BACKGROUND: In curative colorectal cancer surgery, radical lymph node dissection is essential for staging and decision-making for adjuvant treatment. PURPOSE: The aims of the study were to analyse to what extent sentinel lymph node dissection (SLND) in colorectal cancer could upstage N0 patients and how lymphatic mapping could demonstrate micrometastatic disease. PATIENTS AND METHODS: In a prospective study, patients were selected by CT scanning, avoiding bulky disease and distant metastasis. When standard staining (HE) was negative, micrometastases were searched for by immunohistochemistry (cytokeratin 11, CEA and Ca19-9 antibodies). Micrometastatic lymph nodes were classified N+(i). RESULTS: Detection of sentinel lymph nodes was successful in 48 out of 52 colorectal cancer patients. Among the 44 M0 patients, 22 were N0 (i-) and 22 were N+ (13 with standard HE procedure, three were N+ (macrometastasis) with the SN as the only positive node and six patients had 1-4 micrometastatic SN (N+(i)). An overall potential upstaging of 9/44 could be considered after SLND. With a mean follow-up of 48 months survival, analysis showed that disease-specific survival of the group of six N+(i) patients was intermediate between the group of 22 N0 (i-) patients and the group of 16 N+ patients. CONCLUSION: SLND may improve the detection of metastasis in conventionally bivalved nodes. Further studies could assess if micrometastatic disease detected in SN could be integrated into the risk factors for stage II patients in order to consider adjuvant chemotherapy.
Keywords
Adenocarcinoma/pathology, Adenocarcinoma/secondary, Adult, Aged, Aged, 80 and over, Colorectal Neoplasms/pathology, Colorectal Neoplasms/secondary, Female, Humans, Immunohistochemistry, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Prospective Studies, Sentinel Lymph Node Biopsy
Pubmed
Web of science
Create date
29/01/2008 18:34
Last modification date
20/08/2019 15:06
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