INTRODUCTION: Sentinel node mapping is established in some superficial cancers but remains controversial in harder-to-access solid tumors. There are an increasing number of recent studies suggesting that isolated tumor cells have prognostic significance in predicting poor survival, in breast cancer, esophageal cancer, and others. It is for this reason that we have persevered with the sentinel lymph node concept in our esophagectomy cancer patients, and we report our results since 2008. METHODS: Thirty-one of 32 consecutive patients underwent resection for invasive esophageal cancer along with sentinel lymph node retrieval (resection rate, 97%). Peritumoral injection of (99m)Tc antimony colloid was performed by upper endoscopy prior to the operation. A two-surgeon synchronous approach via a right thoracotomy and laparotomy was performed with a conservative lymphadenectomy. Sentinel lymph nodes were identified with a gamma probe both in and ex vivo, and sent off separately for three serial sections and immunohistochemistry with AE1/AE3. RESULTS: The median patient age was 63.4 years (range, 45-75 years). Most patients (81%) had an adenocarcinoma, and 61% had received neoadjuvant therapy. At least one sentinel lymph node (median, 3) was identified in 29 of 31 patients (success rate, 94%). Sentinel nodes were present in more than one nodal station in 16 patients (55%). One false negative case led to a sensitivity of 90%. In 28 of 29 patients, the sentinel lymph node accurately predicted findings in non-sentinel nodes (accuracy, 96%). CONCLUSIONS: Sentinel lymph node biopsy is both feasible and accurate in esophageal resections with conservative lymphadenectomy. It allows targeted serial sectioning and immunohistochemical studies of those nodes and should become standard of care in patients undergoing esophagectomy for esophageal cancer.
INTRODUCTION: Sentinel node mapping is established in some superficial cancers but remains controversial in harder-to-access solid tumors. There are an increasing number of recent studies suggesting that isolated tumor cells have prognostic significance in predicting poor survival, in breast cancer, esophageal cancer, and others. It is for this reason that we have persevered with the sentinel lymph node concept in our esophagectomy cancerpatients, and we report our results since 2008. METHODS: Thirty-one of 32 consecutive patients underwent resection for invasive esophageal cancer along with sentinel lymph node retrieval (resection rate, 97%). Peritumoral injection of (99m)Tc antimony colloid was performed by upper endoscopy prior to the operation. A two-surgeon synchronous approach via a right thoracotomy and laparotomy was performed with a conservative lymphadenectomy. Sentinel lymph nodes were identified with a gamma probe both in and ex vivo, and sent off separately for three serial sections and immunohistochemistry with AE1/AE3. RESULTS: The median patient age was 63.4 years (range, 45-75 years). Most patients (81%) had an adenocarcinoma, and 61% had received neoadjuvant therapy. At least one sentinel lymph node (median, 3) was identified in 29 of 31 patients (success rate, 94%). Sentinel nodes were present in more than one nodal station in 16 patients (55%). One false negative case led to a sensitivity of 90%. In 28 of 29 patients, the sentinel lymph node accurately predicted findings in non-sentinel nodes (accuracy, 96%). CONCLUSIONS: Sentinel lymph node biopsy is both feasible and accurate in esophageal resections with conservative lymphadenectomy. It allows targeted serial sectioning and immunohistochemical studies of those nodes and should become standard of care in patients undergoing esophagectomy for esophageal cancer.
Authors: Sarah K Thompson; Andrew R Ruszkiewicz; Glyn G Jamieson; Thomas R Sullivan; Peter G Devitt Journal: Ann Surg Date: 2010-08 Impact factor: 12.969
Authors: Stephan Gretschel; Andreas Bembenek; Michael Hünerbein; Stefan Dresel; Wolfgang Schneider; Peter M Schlag Journal: Ann Surg Oncol Date: 2007-04-24 Impact factor: 5.344
Authors: Maaike de Boer; Carolien H M van Deurzen; Jos A A M van Dijck; George F Borm; Paul J van Diest; Eddy M M Adang; Johan W R Nortier; Emiel J T Rutgers; Caroline Seynaeve; Marian B E Menke-Pluymers; Peter Bult; Vivianne C G Tjan-Heijnen Journal: N Engl J Med Date: 2009-08-13 Impact factor: 91.245
Authors: Mohammad A Bhat; Zahoor A Naikoo; Tufail A Dass; Riyaz A Lone; Abdul M Dar Journal: Saudi J Gastroenterol Date: 2010 Jul-Sep Impact factor: 2.485
Authors: Gijsbert I van Boxel; B Feike Kingma; Frank J Voskens; Jelle P Ruurda; Richard van Hillegersberg Journal: J Thorac Dis Date: 2020-02 Impact factor: 2.895
Authors: Krista J Hachey; Denis M Gilmore; Katherine W Armstrong; Sean E Harris; Jason L Hornick; Yolonda L Colson; Jon O Wee Journal: J Thorac Cardiovasc Surg Date: 2016-04-11 Impact factor: 5.209
Authors: Stefan Gabrielson; Jon A Tsai; Fuat Celebioglu; Magnus Nilsson; Ioannis Rouvelas; Mats Lindblad; Annie Bjäreback; Artur Tomson; Rimma Axelsson Journal: Nucl Med Commun Date: 2020-11 Impact factor: 1.698