PURPOSE: To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. PATIENTS AND METHODS: Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1% isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti-carcinoembryonic antigen and anticytokeratin antibodies. RESULTS: Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%). CONCLUSION: By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.
PURPOSE: To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. PATIENTS AND METHODS: Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1% isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti-carcinoembryonic antigen and anticytokeratin antibodies. RESULTS: Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%). CONCLUSION: By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.
Authors: Hannes J Larusson; Urs von Holzen; Carsten T Viehl; Farid Rezaeian; Hans-Martin Riehle; Daniel Oertli; Ulrich Guller; Markus Zuber Journal: Int J Colorectal Dis Date: 2014-04-25 Impact factor: 2.571
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: Andreas E Bembenek; Robert Rosenberg; Elke Wagler; Stephan Gretschel; Andreas Sendler; Joerg-Ruediger Siewert; Jörg Nährig; Helmut Witzigmann; Johann Hauss; Christian Knorr; Arno Dimmler; Jörn Gröne; Heinz-Johannes Buhr; Jörg Haier; Hermann Herbst; Juergen Tepel; Bence Siphos; Axel Kleespies; Alfred Koenigsrainer; Nikolas H Stoecklein; Olaf Horstmann; Robert Grützmann; Andreas Imdahl; Daniel Svoboda; Christian Wittekind; Wolfgang Schneider; Klaus-Dieter Wernecke; Peter M Schlag Journal: Ann Surg Date: 2007-06 Impact factor: 12.969