#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Lymphatic Mapping and Biopsy of Sentinel Lymph Nodes Using Combined Methodology of In Vivo Application of Patentblue and Radionuclide and Ex Vivo Detection of Metastatic Affection of Lymph Nodes in Colorectal Carcinoma


Authors: J. Duben 1,2;  B. Dudešek 1;  L. Hnátek 1,2;  P. Vážan 3;  J. Bakala 2,4;  J. Gatěk 1,2
Authors place of work: Chirurgické oddělení nemocnice Atlas a. s. Zlín 1;  Univerzita Tomáše Bati ve Zlíně 2;  Bioptická a cytologická laboratoř, vedoucí lékař MUDr. Josef Velecký 3;  Oddělení nukleární medicíny BN Zlín, přednosta prim. MUDr. Jiří Bakala 4
Published in the journal: Rozhl. Chir., 2010, roč. 89, č. 11, s. 695-701.
Category: Monothematic special - Original

Summary

Aim of the study:
to check the new technique of lymphatic mapping and sentinel node biopsy by colorectal cancer surgery and to improve the lymphatic staging.

Method:
combined technique of lymphatic mapping via Patentblue and the radiocolloid in vivo applied in the rectal cancer surgery. The lymphatic-mapping technique with Patentblue in the colon cancer surgery. Radically or palliative tumour resection. Ex vivo detection of sentinel and non-sentinel lymph nodes in the specimen and their division into peritumoral, intermedial and central level. Serial sectioning examination and immunohistochemistry examination of detected lymph nodes. Statistic process.

Results:
The methods were used for 107 patients. 1985 lymph nodes were examined, out of which 208 was with metastasis. Positive nodes were detected in 56 patients. In average there were 18.5 nodes per patient. 966 sentinel nodes were detected by colouring and radiocolloid marking. Sentinel nodes showed in 97 patients. In 10 patients, the method failed. In 44 patients, sentinel nodes were positive; 117 positive nodes in total. Skip metastases were detected in 6 percent of the patients. The upstaging of metastatic detection was in 3.7 percent.

Conclusion:
The technique of lymphatic mapping and sentinel node detection significantly increases the number of detected nodes and selects the marks the sentinel ones for further examination. The greatest amount of findings of nodal metastases is in the area closest to the tumour, therefore, when sentinel nodes are negative there, these can be examined more closely, by the method of serial insections or imunohistochemically, and staging of the disease can be made more accurate.

Key word:
colorectal cancer – sentinel lymph node – lymphatic mapping


Zdroje

1. Hadrcastle, J. D., Chamberlain, J., Robinson, M., et al. Randomised control trial of faecal occult blood screening for colorectal cancer. Lancet, 348, 1996, 1472–1477

2. Mandel, J. S., Bond, J. H., Church, T. R., et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. N. Engl. J. Med., 328, 1993, 1365–1371.

3. Žaloudík, J., Vyzula, R., Vorlíček, J. Onkoprevence pro Českou republiku. Klinická onkologie, 19, 2006, 35–36.

4. Lehnert, T., Weitz, J., Schaible, A., Herfart, C. Aktuelle Operationstechnik beim kolorektalen Karzinom, Visceralchirurgie, 35, 2000, 187–194.

5. Hohenberger, W., Merkel, S., Weber, K. Lymphadenektomie bei Tumoren des unteren Gastroitestinaltraktes. Chirurg, 78, 2007, 217–225.

6. Lehnert, Th., Herfarth, Ch. Grundlagen und Wert der Lymphadenektomie beim colorectalen Karcinom. Chirurg, 67, 1996, 889–899.

7. MacFarlane, J. K., Ryall, R. D. H., Heald, R. J. Mesorectal excision for rectal cancer, Lancet, 341, 1993, 457–460.

8. Lacy, A. M., Garciá-Valdecasas, J. C., Delgado, S., et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet, 359, 2002, 2224–2229.

9. Coufal, O., Svobodník, A., Žaloudík, J., Šefr, R., Fait, V., Dušek, L., Dorociak, F. Faktory ovlivňující vyšetřování mízních uzlin v resekátech karcinomů kolon a rekta, Klinická onkologie, 17, 3, 2004, 96–100.

10. Coufal, O., Žaloudík, J., Svobodník, A., Šefr, R., Penka, I., Kaplan, Z., Tomášek, J., Fait, V. Standardní klasifikace kolorektálních karcinomů – realita nebo iluze? Klinická onkologie, 6, 2002, 219–225.

11. Fleming, I. D., Cooper, J. S., Henson, D. E., et al. AJCC cancer staging handbook from the AJCC cancer staging manual. 5th ed. Philadelphia: Lippincott Williams and Wilkins, 1998, pp. 81–89.

12. Cohen, A. M., Kelsen, D., Saltz, L., et al. Adjuvant therapy for colorectal cancer. Curr. Prob. Cancer, 22, 1998: 55–65.

13. Herrera-Omelas, L., Justiniano, J., Castillo, N., et al. Metastasis in small lymph nodes from colon cancer. Arch Surg, 122, 1987: 1253–1256.

14. Gusterson, B. Are micrometastase clinically relevant? Br. J. Hosp. Med., 47, 1992: 247–248.

15. Greenson, J. K., Isenhart, C. E., Rice, R., Mojzisik, C., Houchens, D., Martin, E. W. Identification of occcult micrometastases in pericolic lymph nodes of Dukes B colorectal cancer patients using monoclonal antibodies against cytokeratin and CC49. Correlation with long-term survival. Cancer, 73,1994, 563–569.

16. Broll, R., Schauer, V., Schimmelpenning, H., et al. Prognostic relevance of ccult tumor cells in lymph nodes of colorectal carcinomas. Dis. Colon Rectum, 40, 1997: 1465–1471.

17. Saha, S., Weise, D., Badin, J., et al. Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging. Ann. Surg. Oncol., 7, 2000: 120–124.

18. Tsioulias, G. J., Wood, T. F., Morton, D. L., Bilchik, A. J. Lymphatic mapping and focused analysis of sentinel lymph nodes upstage gastroitestinal neoplasms. Arch. Surg., 135, 2000: 926–932.

19. Vážan, P., Velecký, J., Gatěk, J. Vyšetření sentinelových uzlin u karcinomu prsu pomocí rychlé peroperační biopsie, Čes.- slov. Patol., Praha, 2007, 13–17.

20. Czerni, G. The influence of nodal size on the staging of colorectal carcinomas. J. Clin. Pathol., 55, 2002, 386–390.

21. Czerni, G., Tarján, M., Bori, R. Distance of Lymph Nodes From the Tumor. Arch. Patol. Lab. Med., 125, 2001, 246–249.

22. Saha, S., Patel, M., Bilchik, A., Beutler, T., Zuber, M., Bembenek, A., Kitagawa, Y., Duben, J., Codignola, C., Cserni, G. Validation of sentinel lymph node (SLN) mapping (M) in colon cancer (Cca) over 3 continents: An international experience, ASCO 2007, SSO Annual Meeting Chicago 2008

Štítky
Surgery Orthopaedics Trauma surgery

Článok vyšiel v časopise

Perspectives in Surgery

Číslo 11

2010 Číslo 11
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#