Leili Zarifmahmoudi1, Hamidreza Ghorbani2, Ramin Sadeghi1, Kayvan Sadri1, Mahmoud Tavakkoli3, Maliheh Keshvari3, Maryam Salehi4. 1. Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2. Department of Urology, Mashhad University of Medical Sciences, Mashhad, Iran. Ghorbanihr@mums.ac.ir. 3. Department of Urology, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
OBJECTIVE: In this study, the validity of sentinel node biopsy procedure as our index test was assessed and compared with bilateral pelvic lymphadenectomy for staging and detecting the regional lymph nodes metastasis in patients with muscle-invasive bladder cancer (MIBC). METHODS: Consecutive series of cases with T1-T4 urothelial MIBC were included. Following the injection of radiotracer, sentinel nodes were sought using a handheld gamma probe and all hot nodes were harvested. Bilateral pelvic lymphadenectomy was done for all patients following sentinel node biopsy. The tumor specimen, sentinel nodes, and excised lymph nodes were evaluated histopathologically. Same as the other midline tumors, detection rate and false negative rates were calculated using patient basis and side basis methods. RESULTS: By evaluating each patient as a unit of analysis, sentinel nodes were detected in 35 of 41 patients (85%), 13/16 (81%) of the neoadjuvant chemotherapy (NAC) and 22/25 (88%) of the no-neoadjuvant chemotherapy (No-NAC) participants. The false negative rate was 3/7 (42%): 1/3 (33%) for NAC, and 2/4 (50%) for No-NAC patients. By evaluating each hemipelvis as a unit of analysis, sentinel nodes were detected in 53 of 82 hemipelves (65%), 19/32 (66%) of the NAC, and 34/50 (68%) of the No-NAC hemipelves. No false-negative result was found by assessing each hemipelvis as a unit of analysis. CONCLUSIONS: Sentinel node biopsy is a feasible method for lymph node staging in MIBC, including patients with a history of NAC. To optimize the sensitivity, the decision regarding the lymphadenectomy is best to be based on the pathological status of sentinel node harvested from each hemipelvis separately as the unilateral finding of a sentinel node, does not rule out the possibility of metastatic involvement of contralateral pelvic lymph nodes.
OBJECTIVE: In this study, the validity of sentinel node biopsy procedure as our index test was assessed and compared with bilateral pelvic lymphadenectomy for staging and detecting the regional lymph nodes metastasis in patients with muscle-invasive bladder cancer (MIBC). METHODS: Consecutive series of cases with T1-T4 urothelial MIBC were included. Following the injection of radiotracer, sentinel nodes were sought using a handheld gamma probe and all hot nodes were harvested. Bilateral pelvic lymphadenectomy was done for all patients following sentinel node biopsy. The tumor specimen, sentinel nodes, and excised lymph nodes were evaluated histopathologically. Same as the other midline tumors, detection rate and false negative rates were calculated using patient basis and side basis methods. RESULTS: By evaluating each patient as a unit of analysis, sentinel nodes were detected in 35 of 41 patients (85%), 13/16 (81%) of the neoadjuvant chemotherapy (NAC) and 22/25 (88%) of the no-neoadjuvant chemotherapy (No-NAC) participants. The false negative rate was 3/7 (42%): 1/3 (33%) for NAC, and 2/4 (50%) for No-NACpatients. By evaluating each hemipelvis as a unit of analysis, sentinel nodes were detected in 53 of 82 hemipelves (65%), 19/32 (66%) of the NAC, and 34/50 (68%) of the No-NAC hemipelves. No false-negative result was found by assessing each hemipelvis as a unit of analysis. CONCLUSIONS: Sentinel node biopsy is a feasible method for lymph node staging in MIBC, including patients with a history of NAC. To optimize the sensitivity, the decision regarding the lymphadenectomy is best to be based on the pathological status of sentinel node harvested from each hemipelvis separately as the unilateral finding of a sentinel node, does not rule out the possibility of metastatic involvement of contralateral pelvic lymph nodes.
Authors: Daphne D D Rietbergen; Erik J van Gennep; Gijs H KleinJan; Maarten Donswijk; Renato A Valdés Olmos; Bas W van Rhijn; Henk G van der Poel; Fijs W B van Leeuwen Journal: Clin Nucl Med Date: 2022-06-18 Impact factor: 10.782
Authors: E J van Gennep; K K H Aben; T J N Hermans; L M C van Hoogstraten; L A L M Kiemeney; J A Witjes; C S Voskuilen; M Deelen; L S Mertens; R P Meijer; J L Boormans; D G J Robbrecht; L V Beerepoot; R H A Verhoeven; T M Ripping; B W G van Rhijn Journal: World J Urol Date: 2021-09-28 Impact factor: 4.226