BACKGROUND: Orderly progression of nodal metastases has been described for melanoma and breast cancer. The first draining lymph node, the sentinel node, is also the first to contain metastases and accurately predicts nodal status. The aim of this study was to assess the feasibility of lymphatic mapping and sentinel node biopsy in colorectal cancer. METHODS: In 50 patients with colorectal cancer patent blue dye was injected around the tumour. After resection of the tumour the specimen was examined to identify blue-stained lymph nodes. Routine histopathological examination was performed on all nodes and the blue, haematoxylin and eosin-stained tumour-negative nodes were tested immunohistochemically. RESULTS: Lymphatic mapping was possible in 35 of 50 patients (70 per cent). Pathological examination with haematoxylin and eosin staining showed lymph node metastases in 20 of 35 patients. In eight of these 20 patients the blue nodes showed tumour, while in 12 the blue nodes were not involved. This represents a false-negative rate of 60 per cent. CONCLUSION: Lymphatic mapping using patent blue dye is feasible in colorectal cancer. The blue-stained nodes do not predict nodal status of the remaining lymph nodes in the resected specimen. The concept of lymphatic mapping and sentinel node identification is not valid for colorectal cancer.
BACKGROUND: Orderly progression of nodal metastases has been described for melanoma and breast cancer. The first draining lymph node, the sentinel node, is also the first to contain metastases and accurately predicts nodal status. The aim of this study was to assess the feasibility of lymphatic mapping and sentinel node biopsy in colorectal cancer. METHODS: In 50 patients with colorectal cancer patent blue dye was injected around the tumour. After resection of the tumour the specimen was examined to identify blue-stained lymph nodes. Routine histopathological examination was performed on all nodes and the blue, haematoxylin and eosin-stained tumour-negative nodes were tested immunohistochemically. RESULTS: Lymphatic mapping was possible in 35 of 50 patients (70 per cent). Pathological examination with haematoxylin and eosin staining showed lymph node metastases in 20 of 35 patients. In eight of these 20 patients the blue nodes showed tumour, while in 12 the blue nodes were not involved. This represents a false-negative rate of 60 per cent. CONCLUSION: Lymphatic mapping using patent blue dye is feasible in colorectal cancer. The blue-stained nodes do not predict nodal status of the remaining lymph nodes in the resected specimen. The concept of lymphatic mapping and sentinel node identification is not valid for colorectal cancer.
Authors: Helene Schou Andersen; Astrid Louise Bjørn Bennedsen; Stefan Kobbelgaard Burgdorf; Jens Ravn Eriksen; Susanne Eiholm; Anders Toxværd; Lene Buhl Riis; Jacob Rosenberg; Ismail Gögenur Journal: Int J Colorectal Dis Date: 2017-02-16 Impact factor: 2.571
Authors: Carsten T Viehl; Christian T Hamel; Walter R Marti; Ulrich Guller; Lukas Eisner; Uz Stammberger; Luigi Terracciano; Hans P Spichtin; Felix Harder; Markus Zuber Journal: World J Surg Date: 2003-11-06 Impact factor: 3.352
Authors: Monica Bertagnolli; Brent Miedema; Mark Redston; Jeannette Dowell; Donna Niedzwiecki; James Fleshman; Jiri Bem; Robert Mayer; Michael Zinner; Carolyn Compton Journal: Ann Surg Date: 2004-10 Impact factor: 12.969