The sentinel lymph node concept in prostate cancer: first results of gamma probe-guided sentinel lymph node identification.

Summary Aim: Evaluation of the significance of lymphoscintigraphy and intraoperative probe measurement for the identification of the sentinel lymph node (SLN) in prostate cancer. Patients and method: In 117 patients with prostate cancer scintigrams in various projections were acquired till approximately 6 hours p.i. after ultrasound guided transrectal intraprostatic injection of 99mTc-Nanocoll ®. On the following day the SLNs were identified in the operation theatre with a gamma probe and removed. Pelvic standard lymph node dissection followed SLNE. Results: In three of 117 patients with preoperative lymphoscintigraphy no SLN was scintigraphically detectable. These three patients had antecedent transurethral resection of the prostate. In 113 of the residual 114 patients SLN could be intraoperatively localized. In the mean four SLNs per patient were removed. 28 of 117 patients had pelvic lymph node metastases. In 25 cases SLN were right-positive, in one false-negative and in one intraoperatively not detectable. In one patient we found macrometastasis of up to 4 cm diameter (one SLN was tumour positive). In 15 cases only the SLN was bearing tumour. Conclusion: The SLNE with preoperative lymphoscintigraphy and intraoperative gamma probe measurement is suitable for detecting lymph node metastasis in prostate cancer. SLNE is superior to the surgical techniques commonly used in pelvic lymphadenectomy.

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Use of the gamma probe in sentinel lymph node biopsy in patients with prostate cancer

Nuclear Medicine Communications ◽

10.1097/00006231-200512000-00006 ◽

2005 ◽

Vol 26 (12) ◽

pp. 1081-1086 ◽

Cited By ~ 14

Author(s):

Neivo Silva ◽

Carlos E. Anselmi ◽

Osvaldo E. Anselmi ◽

Rafael R. Madke ◽

Angela Hunsche ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Gamma Probe ◽

Lymph Node Biopsy ◽

Node Biopsy

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Hemosiderin: a new marker for sentinel lymph node identification

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502009000600002 ◽

2009 ◽

Vol 24 (6) ◽

pp. 432-436 ◽

Cited By ~ 12

Author(s):

Luiz Gonzaga Porto Pinheiro ◽

Renato Santos de Oliveira Filho ◽

Paulo Henrique Diógenes Vasques ◽

Pedro Henrique de Oliveira Filgueira ◽

Douglas Henning Pinheiro Aragão ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Breast Biopsy ◽

Gamma Probe ◽

Sentinel Lymph Nodes ◽

Patent Blue ◽

Sentinel Lymph Node Identification ◽

Lymphatic Duct ◽

The Right

PURPOSE: To evaluate and present our initial results of a new marker (hemosiderin) for mammary sentinel lymph node identification in an experimental model. METHODS: Skins mapped like a lymphatic duct draining to the axilla in patients submitted to breast biopsy, in our mastology service, stimulated us to try it in an animal model (female dogs). Our theory was that some blood derivate (hemosiderin) was captured by macrophages and accessed the lymphatic ducts in direction to the axilla. Six female dogs of no defined race were studied. We injected 0,2 ml of technetium on both superior mammary glands. After ten minutes, a 2,5 ml solution of hemolized blood (hemosiderin) from the own animal was injected in the subareolar lymphatic plexus on the left superior mammary gland and 2,5 ml of patent blue concomitantly and equally on the contralateral gland. Ten minutes after, incisions on both axilas were made to search, through the lymphatic mapping and a gamma probe, the sentinel lymph nodes. RESULTS: Seven brown sentinel lymph nodes were indentified and also radiomarked on the left axilla. Six blue sentinel lymph nodes were identified and also radiomarked on the right axilla. CONCLUSION: Preliminary studies of a potential new dye for sentinel lymph node identification are presented. It may be the change of the current use of the blue dyes and their severe side-effects on patients submitted to sentinel lymph node biopsies.

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Recent Applications of the Sentinel Lymph Node Concept: Preliminary Experience in Prostate Cancer

Tumori Journal ◽

10.1177/030089160208800326 ◽

2002 ◽

Vol 88 (3) ◽

pp. S16-S17 ◽

Cited By ~ 18

Author(s):

M Rudoni ◽

GM Sacchetti ◽

L Leva ◽

E Inglese ◽

G Monesi ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Lymphatic Drainage ◽

Pelvic Lymphadenectomy ◽

Radioguided Surgery ◽

Transrectal Biopsy ◽

Duration Of Surgery ◽

Sentinel Lymph Node Concept

Aims and Background Following the widespread use of radioguided surgery (RGS) in melanoma and breast cancer, we applied this new surgical strategy to prostate cancer (PC). The aims of this study were 1) to evaluate the accuracy of RGS in the detection of prostatic sentinel lymph nodes (SLN), and 2) to verify if pelvic lymphadenectomy (LAD) is an accurate means to detect solitary micrometastases. Study design We investigated 48 patients with PC confirmed by transrectal biopsy who underwent radical prostatectomy and bilateral LAD. A dose of 99mTc-labeled nanocolloid particles was injected into the prostate after needle positioning by ultrasonography. Serial imaging was obtained with a gamma camera, identifying 1) the first radioactive lymph node (sentinel lymph node, SLN); 2) other radioactive lymph nodes, and 3) non-active lymph nodes. Results Forty-three SLNs were identified in 48 patients. Twenty SLNs were located at unusual sites with respect to the extent of conventional LAD. Five SLNs were positive for micrometastases and two of these were located outside the usual LAD area. No micrometastases were found in any of the remaining lymph nodes (active and non-active). Conclusions These preliminary results are in agreement with the few previous scientific contributions available on this topic and indicate that it is possible to reduce the extent and duration of surgery and necessary to reevaluate the conventional sites of lymphatic drainage.

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