T L Fitzgerald1, M A Khalifa, M Al Zahrani, C H L Law, A J Smith. 1. Division of Surgical Oncology and Department of Pathology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto and Toronto-Sunnybrook Regional Cancer Centre.
Abstract
BACKGROUND AND OBJECTIVES: Sentinel lymph node (SLN) biopsy may improve staging of colorectal cancer. We tested the feasibility of ex vivo SLN dissection. MATERIALS AND METHODS: Patients undergoing resection of a primary colorectal cancer were included in this study. SLN identification involved ex vivo injection of 1 cc isosulfan blue dye subserosally in the colon or submucosally in the rectum on a separate field. SLNs were cut at 2 mm intervals. Three hematoxylin and eosin-stained (HE) sections were prepared in addition to a middle level for cytokeratin immunostaining. RESULTS: Twenty-six patients with varying tumor location and stage were enrolled and the SLN was identified in 88% (23/26) cases. Three failures occurred in patients with rectal cancer. The average number of SLN harvested was 2.5. The status of the nodal basin was accurately predicted in 91% (21/23) of patients. Two false negative sentinel lymph nodes were harvested in 2 of 3 patients with stage III/IV colorectal cancer. The SLN upstaged 2 patients as a result of HE stained step sections (n = 1) and immunostaining (n = 1). CONCLUSIONS: This data suggests that ex vivo SLN biopsy is feasible in colorectal cancer. Although ex vivo SLN biopsy does not alter the lymphatic dissection, it may upstage a subset of patients. The ex vivo technique may be less applicable in rectal cancer and false negative results may occur. Copyright 2002 Wiley-Liss, Inc.
BACKGROUND AND OBJECTIVES: Sentinel lymph node (SLN) biopsy may improve staging of colorectal cancer. We tested the feasibility of ex vivo SLN dissection. MATERIALS AND METHODS:Patients undergoing resection of a primary colorectal cancer were included in this study. SLN identification involved ex vivo injection of 1 cc isosulfan blue dye subserosally in the colon or submucosally in the rectum on a separate field. SLNs were cut at 2 mm intervals. Three hematoxylin and eosin-stained (HE) sections were prepared in addition to a middle level for cytokeratin immunostaining. RESULTS: Twenty-six patients with varying tumor location and stage were enrolled and the SLN was identified in 88% (23/26) cases. Three failures occurred in patients with rectal cancer. The average number of SLN harvested was 2.5. The status of the nodal basin was accurately predicted in 91% (21/23) of patients. Two false negative sentinel lymph nodes were harvested in 2 of 3 patients with stage III/IV colorectal cancer. The SLN upstaged 2 patients as a result of HE stained step sections (n = 1) and immunostaining (n = 1). CONCLUSIONS: This data suggests that ex vivo SLN biopsy is feasible in colorectal cancer. Although ex vivo SLN biopsy does not alter the lymphatic dissection, it may upstage a subset of patients. The ex vivo technique may be less applicable in rectal cancer and false negative results may occur. Copyright 2002 Wiley-Liss, Inc.
Authors: Benjamin Weixler; Andreas Rickenbacher; Dimitri Aristotle Raptis; Carsten T Viehl; Ulrich Guller; Jessica Rueff; Andreas Zettl; Markus Zuber Journal: World J Surg Date: 2017-09 Impact factor: 3.352
Authors: Olivier Baton; Philippe Lasser; Jean-Christophe Sabourin; Valérie Boige; Pierre Duvillard; Dominique Elias; David Malka; Michel Ducreux; Marc Pocard Journal: World J Surg Date: 2005-09 Impact factor: 3.352