BACKGROUND: In colorectal cancer (CRC), colonoscopic tattooing is performed to mark the tumor site before laparoscopic surgery. OBJECTIVE: To determine whether colonoscopic tattooing can be used to refine staging accuracy by increasing the lymph node (LN) yield per specimen and to determine its accuracy as a sentinel LN procedure. DESIGN: Retrospective, case-control study. All LNs were microscopically examined for the presence of carbon particles. SETTING: A university hospital and a teaching hospital. PATIENTS: A consecutive series of 95 tattooed patients who had surgery for CRC between 2005 and 2009. A series of 210 non-tattooed patients who had surgery in the same time period served as controls. MAIN OUTCOME MEASUREMENTS: Total number of LNs retrieved, detection rate, and sensitivity of tattooing as a sentinel node procedure. RESULTS: A higher LN yield was observed in patients with preoperative tattooing, median (interquartile range) 15 (10-20) versus 12 (9-16), (P = .014). In multivariable analysis, the presence of carbon-containing LNs was an independent predictive factor for a higher LN yield (P = .002). The detection rate was 71%, with a median of 5 carbon-containing LNs per specimen. If preoperative tattooing was used for sentinel node mapping, the overall accuracy of predicting LN status was 94%. In the 24 N1 cases, there were 4 false-negative procedures (sensitivity 83%). LIMITATIONS: Retrospective series. CONCLUSION: After tattooing of CRC, the LN yield was higher than in a control group, and it could be used as a sentinel node procedure with acceptable accuracy rates. Because LN yield and sentinel node mapping are associated with improved diagnostic accuracy of LN involvement, preoperative tattooing can refine staging.
BACKGROUND: In colorectal cancer (CRC), colonoscopic tattooing is performed to mark the tumor site before laparoscopic surgery. OBJECTIVE: To determine whether colonoscopic tattooing can be used to refine staging accuracy by increasing the lymph node (LN) yield per specimen and to determine its accuracy as a sentinel LN procedure. DESIGN: Retrospective, case-control study. All LNs were microscopically examined for the presence of carbon particles. SETTING: A university hospital and a teaching hospital. PATIENTS: A consecutive series of 95 tattooed patients who had surgery for CRC between 2005 and 2009. A series of 210 non-tattooed patients who had surgery in the same time period served as controls. MAIN OUTCOME MEASUREMENTS: Total number of LNs retrieved, detection rate, and sensitivity of tattooing as a sentinel node procedure. RESULTS: A higher LN yield was observed in patients with preoperative tattooing, median (interquartile range) 15 (10-20) versus 12 (9-16), (P = .014). In multivariable analysis, the presence of carbon-containing LNs was an independent predictive factor for a higher LN yield (P = .002). The detection rate was 71%, with a median of 5 carbon-containing LNs per specimen. If preoperative tattooing was used for sentinel node mapping, the overall accuracy of predicting LN status was 94%. In the 24 N1 cases, there were 4 false-negative procedures (sensitivity 83%). LIMITATIONS: Retrospective series. CONCLUSION: After tattooing of CRC, the LN yield was higher than in a control group, and it could be used as a sentinel node procedure with acceptable accuracy rates. Because LN yield and sentinel node mapping are associated with improved diagnostic accuracy of LN involvement, preoperative tattooing can refine staging.
Authors: F Bianco; A Arezzo; F Agresta; C Coco; R Faletti; Z Krivocapic; G Rotondano; G A Santoro; N Vettoretto; S De Franciscis; A Belli; G M Romano Journal: Tech Coloproctol Date: 2015-09-24 Impact factor: 3.781
Authors: Michal F Kaminski; Siwan Thomas-Gibson; Marek Bugajski; Michael Bretthauer; Colin J Rees; Evelien Dekker; Geir Hoff; Rodrigo Jover; Stepan Suchanek; Monika Ferlitsch; John Anderson; Thomas Roesch; Rolf Hultcranz; Istvan Racz; Ernst J Kuipers; Kjetil Garborg; James E East; Maciej Rupinski; Birgitte Seip; Cathy Bennett; Carlo Senore; Silvia Minozzi; Raf Bisschops; Dirk Domagk; Roland Valori; Cristiano Spada; Cesare Hassan; Mario Dinis-Ribeiro; Matthew D Rutter Journal: United European Gastroenterol J Date: 2017-03-16 Impact factor: 4.623
Authors: Carlo V Feo; Mattia Portinari; Michele Zuolo; Simone Targa; Vincenzo G Matarese; Roberta Gafà; Elena Forini; Giovanni Lanza Journal: J Negat Results Biomed Date: 2015-05-07