scholarly journals Sentinel Lymph Node Biopsy Using a Single-Dye Technique in a Cancer Center of North-East India

2021 ◽  
Vol 10 (02) ◽  
pp. 69-71
Author(s):  
Gaurav Das ◽  
Revanth Kodali ◽  
Sachin Khanna ◽  
Joydeep Purkayastha ◽  
Abhijit Talukdar ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Paraffin Section ◽  
Cancer Center ◽  
Blue Dye ◽  
Node Negative ◽  
North East India ◽  
North East ◽  
Positive Rate

Abstract Background Sentinel lymph node (SLN) is the first node to receive the drainage directly from a tumor. SLN biopsy can be done in lieu of a formal lymphadenectomy in selected clinically node-negative cancers and minimizes morbidity compared with the latter. Methods This prospective study was done in patients with operable clinically node-negative breast cancer, penile cancer, and malignant melanoma of extremities in a cancer center of North-east India from January 2019 to December 2019. All the patients underwent formal lymph nodal dissection after the SLN biopsy. Besides intraoperative frozen section study of the sentinel node(s), all the specimens, including the sentinel node(s), were subjected to paraffin section histopathology. Results SLN was identified successfully in 96% of patients. Mean number of sentinel node(s) dissected was 2.3. Study of SLN biopsy with methylene blue dye for staging was done with 100% sensitivity and 95.3% specificity. The SLN procedure was able to negatively predict the drainage nodal basin in 100% with an overall accuracy of staging of 96.5%. The true-positive rate noted was 88.8%, and the false-positive rate was 4.6%. Conclusions SLN using a single-dye technique reliably identifies a sentinel node. This procedure can be safely adopted in patients with node-negative cancers as mentioned above to pathologically study the drainage basin.

First experiences with a new radiopharmaceutical for sentinel lymph node detection in malignant melanoma

2004 ◽  
Vol 43 (01) ◽  
pp. 10-15 ◽  
Author(s):  
R. A. Schmid ◽  
C. Kunte ◽  
B. Konz ◽  
K. Hahn ◽  
M. Weiss
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Malignant Melanoma ◽  
Sentinel Node ◽  
Gamma Probe ◽  
Blue Dye ◽  
Sentinel Nodes ◽  
Technetium 99M ◽  
Positive Rate ◽  
Metastatic Involvement

Summary Aim of this study was to localize the sentinel lymph node by lymphoscintigraphy using technetium-99m colloidal rhenium sulphide (Nanocis®), a new commercially available radiopharmaceutical. Due to the manufacturers’ instructions it is licensed for lymphoscintigraphy. Patients, methods: 35 consecutive patients with histologically proved malignant melanoma, but without clinical evidence of metastases, were preoperatively examined by injecting 20-40 MBq Nanocis® with (mean particle size: 100 nm; range: 50-200 nm) intradermally around the lesion. Additionally blue dye was injected intaoperatively. A hand-held gamma probe guided sentinel node biopsy. Results: During surgery, the preoperatively scintigraphically detected sentinel lymph nodes were identified in 34/35 (97%) patients. The number of sentinel nodes per patient ranged from one to four (mean: n = 1.8). Histologically, metastatic involvement of the sentinel lymph node was found in 12/35 (34%) patients; the sentinel lymph node positive-rate (14/63 SLN) was 22%. Thus, it is comparable to the findings of SLN-mapping using other technetium-99m-labeled nanocolloides. Conclusion: 99mTc-bound colloidal rhenium sulphide is also suitable for sentinel node mapping.

scholarly journals Failure of Radiotracer Migration: Salvaging Sentinel Lymph Node Biopsy in Melanoma Care With Indocyanine Green

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110222
Author(s):  
Christine Nicholas ◽  
Carmen Webb ◽  
Claire Temple-Oberle
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Sentinel Node ◽  
Head And Neck ◽  
Near Infrared ◽  
False Negative ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Traditional Methods

Reducing false negative rates for sentinel lymph node biopsies (SLNB) in melanoma is important to accurately prognosticate and to guide treatment. Traditionally, SLNB has been performed with the adjunct of radiotracers and blue dye. Although sentinel node mapping is highly successful in axillary and inguinal node basins, identification of nodes in the head and neck is not as accurate with traditional methods. One reason for this may be failure of radiotracer migration. To augment standard technique using a radiocolloid, indocyanine green (ICG) combined with near infrared spectroscopy (NIRS), has shown promising results. We demonstrate a case of an individual undergoing SLNB in the head and neck region with failure of radiotracer migration. Identification of a sentinel node was accomplished with the use of ICG and NIRS. This technology offers an opportunity to salvage the SLNB when traditional methods fail.

scholarly journals Evolution and outcomes of sentinel lymph node mapping in vulvar cancer

2020 ◽  
Vol 30 (3) ◽  
pp. 383-386 ◽  
Author(s):  
Vance Broach ◽  
Nadeem R Abu-Rustum ◽  
Yukio Sonoda ◽  
Carol L Brown ◽  
Elizabeth Jewell ◽  
...  
Keyword(s):  
At Risk ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Squamous Cell ◽  
Vulvar Cancer ◽  
Cancer Center ◽  
Blue Dye ◽  
Left Groin ◽  
Detection Techniques

ObjectivesTo characterize our institutional experience with sentinel lymph node (SLN) biopsy in patients with vulvar cancer. We describe the oncologic outcomes of these patients and the utilization of SLN detection techniques over time.MethodsA retrospective analysis of all patients who underwent inguinofemoral SLN biopsy as part of their treatment for vulvar cancer at Memorial Sloan Kettering Cancer Center from January 1, 2000 to April 1, 2019. Patients were included in this analysis if they underwent inguinofemoral SLN biopsy for vulvar cancer, irrespective of presenting factors such as histology, tumor size or laterality. An “at-risk groin” was defined as either the right or left groin for which SLN biopsy of inguinofemoral lymph nodes was performed.ResultsA total of 160 patients were included in our analysis, representing 265 at-risk groins. 114 patients had squamous cell histology representing 195 at-risk groins. Of the 169 negative groins in patients with squamous cell carcinoma, the 2 year isolated groin recurrence rate was 1.2%. SLN detection rate, irrespective of modality, was 96.2%. Technetium-99 (TC-99) + blue dye detected SLNs in 91.8% of groins; TC-99 + indocyanine green detected SLNs in 100% of groins (p=0.157). Among the 110 groins that underwent mapping with TC-99 and blue dye, 4 patients had failed mapping with blue dye and mapped with TC-99 alone (3.6%). Among the 96 groins that underwent mapping with TC-99 and ICG, 14 patients failed to map with TC-99 and mapped with indocyanine green alone (14.6%).ConclusionsSLN mapping in vulvar cancer is reliable and oncologically effective. The utilization of indocyanine green for mapping has increased over the past decade and is associated with high rates of SLN detection.

Evidence-Based Clinical Practice Guidelines on the Use of Sentinel Lymph Node Biopsy in Melanoma

2013 ◽  
pp. e320-e325
Author(s):  
Vernon K. Sondak ◽  
Sandra L. Wong ◽  
Jeffrey E. Gershenwald ◽  
John F. Thompson
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Primary Melanoma ◽  
Lymph Node Biopsy ◽  
Evidence Based ◽  
Node Negative ◽  
Nodal Basin ◽  
Node Biopsy

Sentinel lymph node biopsy (SLNB) was introduced in 1992 to allow histopathologic evaluation of the “sentinel” node, that is, the first node along the lymphatic drainage pathway from the primary melanoma. This procedure has less risk of complications than a complete lymphadenectomy, and if the sentinel node is uninvolved by tumor the likelihood a complete lymphadenectomy would find metastatic disease in that nodal basin is very low. SLNB is now widely used worldwide in the staging of melanoma as well as breast and Merkel cell carcinomas. SLNB provides safe, reliable staging for patients with clinically node-negative melanomas 1 mm or greater in thickness, with an acceptably low rate of failure in the sentinel node-negative basin. Evidence-based guidelines jointly produced by ASCO and the Society of Surgical Oncology (SSO) recommend SLNB for patients with intermediate-thickness melanomas and also state that SLNB may be recommended for patients with thick melanomas. Major remaining areas of uncertainty include the indications for SLNB in patients with thin melanomas, pediatric patients, and patients with atypical melanocytic neoplasms; the optimal radiotracers and dyes for lymphatic mapping; and the necessity of complete lymphadenectomy in all sentinel node-positive patients.

scholarly journals Value of sentinel lymph node mapping using a blue dye-only method in gastric cancer: a single-center experience from North-East Hungary

2011 ◽  
Vol 14 (4) ◽  
pp. 360-364 ◽  
Author(s):  
Dezső Tóth ◽  
Zsolt Kincses ◽  
János Plósz ◽  
Miklós Török ◽  
Ilona Kovács ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Mapping ◽  
Blue Dye ◽  
Single Center ◽  
Lymph Node Mapping ◽  
North East ◽  
Single Center Experience

scholarly journals Axillary dissection versus non dissection in negative sentinel node biopsy patients

2019 ◽  
Vol 6 (9) ◽  
pp. 3083
Author(s):  
Hossam Abd Ellatif Abo Elkasem ◽  
Ahmed Abdel Kahaar Aldardeer
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Axillary Dissection ◽  
Node Negative ◽  
Node Biopsy ◽  
Group A ◽  
Group B

Background: The goal of this series was to compare performing axillary clearance versus none performing in patients with node biopsy negative.Methods: This study included 114 patients had breast cancer , presented with breast mass no enlarged axillary node either clinically or radiologically and all patients had negative sentinel lymph node intraoperatively those patients presented to Sohag Cancer Center and General Surgery Department Sohag, Egypt during the period of May 2018 to May 2019. Analysis of the clinical presentation, grade of breast cancer and radiological findings was done. All patients with above mentioned criteria were fitted for the study.Results: A total of 114 patients, all of them had sentinel lymph node negative, axillary dissection done in 55 patients of them while 59 patients had no dissection. We divided the patients in our series into group A (with axillary dissection) and group B with non-dissection; in group A 27 (49.1%) patients had lymphoedema on post-operative follow up while in group B none of patients complained from lymphoedema. Numbness was found in 11 (20%) patients among group A patients, while in group B none of patients complained from numbness. On follow up of seroma we discovered that in group A all the patients had seroma while in group B only 9 (15.3%) patients had seroma. None of our 114 patients either with or without dissection had recurrence on follow up period.Conclusions: Clearance of the axilla in sentinel node negative patients has no significant difference in overall survival but also increased rates of lymphoedema, seroma and haematoma. 

scholarly journals Sentinel lymph node identification in early stage ovarian cancer: is it still possible after prior tumor resection?

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Pim Laven ◽  
Roy Kruitwagen ◽  
Petra Zusterzeel ◽  
Brigitte Slangen ◽  
Toon van Gorp ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Early Stage ◽  
Frozen Section ◽  
Gamma Probe ◽  
Tumor Resection ◽  
Blue Dye ◽  
Sentinel Nodes

Abstract Objective Sentinel lymph node (SLN) detection in ovarian cancer is feasible when tracers are injected before the pathological ovary is resected. This study aims to investigate whether the SLN identification is also feasible in patients whose ovarian tumor has already been resected with injection of the tracer into the ovarian ligaments stumps, i.e. in the event that a frozen section confirms malignancy. Methods Patients who underwent laparotomy with frozen section confirming an ovarian malignancy, and those who underwent a second staging laparotomy after prior resection of a malignant ovarian mass, were included. Blue dye and a radioactive isotope were injected in the stumps of the ligamentum ovarium proprium and the ligamentum infundibulo-pelvicum. After an interval of at least 15-min, the sentinel node(s) were identified using either the gamma-probe and / or blue dye. Results A total of 11 patients were included in the study, the sentinel node (SLN) procedure was completed in all 11 patients. At least one SLN was identified in 3 patients, resulting in a rather low detection rate of 27,3%. Conclusion In this study we showed that SLN procedure after (previous) resection of the tumor seems inferior to detect sentinel nodes when compared to injection of the tracer in the ovarian ligaments before tumor resection. Trial registration NCT02540551

Sentinel lymph node in endometrial cancer

2007 ◽  
Vol 17 (5) ◽  
pp. 1113-1117 ◽  
Author(s):  
L.A.F Lopes ◽  
S. M Nicolau ◽  
F. F Baracat ◽  
E. C Baracat ◽  
W. J Gonçalves ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Sentinel Node ◽  
Endometrial Carcinoma ◽  
Frozen Section ◽  
False Negative ◽  
Pelvic Lymphadenectomy ◽  
Clinical Staging ◽  
Blue Dye

The aim of this study was to evaluate the possibility of identifying the sentinel lymph node and involvement of neoplastic cells in patients with endometrial carcinoma limited to the uterus, and also its correlation with the conditions of other pelvic and para-aortic lymph nodes. Forty patients with endometrial carcinoma, clinical staging I and II, were submitted to complete surgical staging through laparotomy, as recommended by FIGO in 1988. The sentinel node was investigated using patent blue dye in the myometrial subserosa. The sentinel node was excised and submitted to frozen section examination of specimen, stained with hematoxylin and eosin (H&E). Afterward, selective bilateral para-aortic and pelvic lymphadenectomy, total hysterectomy with bilateral salpingo-oophorectomy were performed. The lymph nodes excised were examined by means of paraffin-embedded slices stained with H&E and of imunohistochemistry with antikeratin antibody AE1/AE3. The sentinel lymph node was identified in 77.5% of patients (31/40), and 16.1% (5/31) presented neoplastic involvement in the node. In 25 cases of negative sentinel node, 96% (24/25) had no neoplastic involvement, and 4% (1/25) had other lymph node affected (false negative). In nine cases with no sentinel node identified, 55.5% (5/9) had lymph node involvement. The results of this study allow us to conclude that it is possible to identify the sentinel node using the methods described, and the pathologic examination significantly represents the same conditions of other pelvic and para-aortic lymph nodes.

scholarly journals Sentinel Lymph Node Biopsy in SCC of the Head and Neck: A Major Advance in Staging the NO Neck

2002 ◽  
Vol 81 (3) ◽  
pp. 156-163 ◽  
Author(s):  
Sam M. Wiseman ◽  
Thorn R. Loree ◽  
Wesley L. Hicks ◽  
Nestor R. Rigual
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Node Biopsy

The management of the NO neck in patients with head and neck cancer is controversial. Neck dissection provides important staging information that guides patient treatment. We examined the feasibility of using a dye technique for staging patients by sentinel lymph node biopsy (SLNBX). We studied seven patients with previously untreated early-stage squamous cell carcinoma of the oral cavity and NO necks. Each patient underwent SLNBX guided by an intraoperative injection of 1% isosulfan blue dye. An open biopsy of the sentinel node was followed by neck dissection. We identified the sentinel node in four of the seven patients (57%). The sentinel node accurately predicted the pathologic status of the neck in three of these four patients (75%). In one of the three patients, the sentinel node was one of four histopathologically positive nodes, whereas in two others, the neck was free of disease. One patient had a histopathologically negative sentinel node and tumor metastasis present in the neck. Of the four patients in whom a sentinel node was identified, the negative predictive value for the absence of cervical metastases was 67%. Based on our findings and those of other authors, we conclude that the use of blue dye in lymphatic mapping for SLNBX in head and neck cancer patients is technically feasible but of limited clinical utility. Our literature review also suggests that performing SLNBX with a radiotracer technique or a combination of a radiotracer and blue dye is a promising method of staging the NO neck in head and neck cancer patients and warrants further clinical study.

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