Hyun Koo Kim1, SeungEun Kim, Jong Jae Park, Jae Min Jeong, Young Jae Mok, Young Ho Choi. 1. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Guro Hospital, and Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Abstract
BACKGROUND: This study is a clinical trial designed to test the reliability and feasibility of sentinel node detection using a new mannose receptor radioactive binding agent in patients with esophageal squamous cell carcinoma. METHODS: Twenty-three patients (21 men, 2 women; mean age 61.0±8.60 years) who were candidates for esophagectomy with conventional lymph node dissection for thoracic esophageal cancer were enrolled. A total dose of 1 mCi of 99mTc-MSA [technetium-99m neomannosyl human serum albumin] in 0.2 mL was administered at 4 quadrants into the submucosal layer around the primary tumor under esophagoscopic guidance approximately 1 hour before surgery. Intraoperative sentinel node sampling was subsequently followed by esophagectomy. All harvested lymph nodes were cut into 2-mm slices and ultimately diagnosed using formalin-fixed and paraffin-embedded sections with hematoxylin and eosin staining. RESULTS: The number of dissected lymph nodes per patient was 30.5±9.18 (15-47). Among 23 patients, the sentinel lymph nodes could be identified in 21 patients (91.3%). The sentinel nodes could be identified in all 21 patients with cT1 or T2N0M0 (100%) disease; these patients were candidates for sentinel lymph node navigation surgery for the esophageal cancer. The mean number of sentinel nodes identified was 2.6±1.35 (range, 1-5) per patient. No false-negative sentinel lymph nodes were detected in any of the 8 patients with node-positive disease (0%). CONCLUSIONS: Intraoperative sentinel lymph node identification using 99mTc-MSA was feasible and reliable in patients with esophageal squamous cell carcinoma.
BACKGROUND: This study is a clinical trial designed to test the reliability and feasibility of sentinel node detection using a new mannose receptor radioactive binding agent in patients with esophageal squamous cell carcinoma. METHODS: Twenty-three patients (21 men, 2 women; mean age 61.0±8.60 years) who were candidates for esophagectomy with conventional lymph node dissection for thoracic esophageal cancer were enrolled. A total dose of 1 mCi of 99mTc-MSA [technetium-99m neomannosyl human serum albumin] in 0.2 mL was administered at 4 quadrants into the submucosal layer around the primary tumor under esophagoscopic guidance approximately 1 hour before surgery. Intraoperative sentinel node sampling was subsequently followed by esophagectomy. All harvested lymph nodes were cut into 2-mm slices and ultimately diagnosed using formalin-fixed and paraffin-embedded sections with hematoxylin and eosin staining. RESULTS: The number of dissected lymph nodes per patient was 30.5±9.18 (15-47). Among 23 patients, the sentinel lymph nodes could be identified in 21 patients (91.3%). The sentinel nodes could be identified in all 21 patients with cT1 or T2N0M0 (100%) disease; these patients were candidates for sentinel lymph node navigation surgery for the esophageal cancer. The mean number of sentinel nodes identified was 2.6±1.35 (range, 1-5) per patient. No false-negative sentinel lymph nodes were detected in any of the 8 patients with node-positive disease (0%). CONCLUSIONS: Intraoperative sentinel lymph node identification using 99mTc-MSA was feasible and reliable in patients with esophageal squamous cell carcinoma.
Authors: Hideyuki Wada; Hoon Hyun; Kai Bao; Jeong Heon Lee; Georges El Fakhri; Yongdoo Choi; Hak Soo Choi Journal: Chem Eng J Date: 2018-01-03 Impact factor: 13.273