Lymphatic Mapping and Sentinel Node 		 Identification for Colorectal Cancer

The primary treatment of resectable CRC is surgical resection. Postoperative adjuvant therapies are recommended when lymph node metastases are found (stage III). There is evidence that about 20% of node negative CRC cases (stage II) are understaged, i.e., they are actually node positive (stage III). New intraoperative procedures (lymphatic mapping and sentinel node identification) that are able to detect occult macro- and micrometastases. Molecular assessment of nodal disease should improve the current staging criteria for colon cancer and could influence recommendation for adjuvant treatment.

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Current Perspectives on Lymphatic Mapping in Carcinomas of the Uterine Corpus and Cervix

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2006.0039 ◽

2006 ◽

Vol 4 (5) ◽

pp. 471-478 ◽

Cited By ~ 4

Author(s):

Robert L. Coleman ◽

Michael Frumovitz ◽

Charles F. Levenback

Keyword(s):

Sentinel Node ◽

Lymphatic Mapping ◽

Female Genital Tract ◽

Standard Of Care ◽

Lymphatic Drainage ◽

Sentinel Node Identification ◽

Rare Malignancy ◽

Clinical Potential ◽

Current Experience ◽

Female Genital

Lymphatic mapping and sentinel node identification are rapidly becoming the standard of care in managing many malignancies. These procedures have allowed focused evaluation of relevant regional lymphatics, which has led not only to improved precision of nodal pathology, but also to treatment triage and the potential for reduced postoperative morbidity. Given its clinical potential, new cancer primary sites are being evaluated, including those of the female genital tract. Of these, carcinoma of the vulva seems the most apposite; however, it is a rare malignancy and therefore large randomized treatment trials based on sentinel node triage are difficult to perform. Cancers of the uterus–cervix and corpus are more common. Because the physiologic lymphatic drainage from this organ is ambiguous, principle lymphatic basins are located in many different anatomic locales, making sentinel node identification precarious, yet highly relevant and informative. Current experience in carcinoma of the cervix suggests the concept is feasible. A consensus in corpus cancer has not been reached, although both sites are of keen interest with the increasing use of laparoscopy in surgical management. Prospective multi-institutional validation studies are underway.

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Intraoperative Lymphatic Mapping and Sentinel Node Identification: Gynecologic Applications

Recent Results in Cancer Research - Lymphatic Metastasis and Sentinel Lymphonodectomy ◽

10.1007/978-3-642-57151-0_13 ◽

2000 ◽

pp. 150-158 ◽

Cited By ~ 21

Author(s):

C. Levenback

Keyword(s):

Sentinel Node ◽

Lymphatic Mapping ◽

Sentinel Node Identification

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Sentinel node detection with radiocolloid lymphatic mapping in early invasive cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200503000-00014 ◽

2005 ◽

Vol 15 (2) ◽

pp. 273-277 ◽

Cited By ~ 2

Author(s):

Y. S. Lin ◽

C. C. Tzeng ◽

K. F. Huang ◽

C. Y. Kang ◽

C. C. Chia ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Sentinel Node ◽

Lymph Node Metastases ◽

Lymphatic Mapping ◽

Invasive Cervical Cancer ◽

False Negative ◽

Sentinel Node Detection ◽

Sentinel Nodes ◽

Node Metastases

We assessed the feasibility of sentinel lymph node detection using technicium-99 radiocolloid lymphatic mapping for predicting lymph node metastases in early invasive cervical cancer. Thirty patients with cervical cancer (stages IA2–IIA) underwent preoperative lymphoscintigraphy using technicium-99 intracervical injection and intraoperative lymphatic mapping with a handheld gamma probe. After dissection of the sentinel nodes, the standard procedure of pelvic lymph node dissection and radical hysterectomy was performed as usual. The sentinel node detection rate was 100% (30/30). There were seven (23.3%) cases of microscopic lymph node metastases on pathologic analysis. All of them had sentinel node involvement. Therefore, the sensitivity of sentinel node identification for prediction of lymph node metastases was 100%, and no false negative was found. Preoperative lymphoscintigraphy, coupled with intraoperative lymphatic mapping, located the sentinel nodes accurately in our study patients. This sentinel node detection method appears to be feasible for predicting lymph node metastases

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