Radioguided sentinel lymph node detection in vulvar cancer

2005 ◽  
Vol 15 (3) ◽  
pp. 493-497 ◽  
Author(s):  
C. Merisio ◽  
R. Berretta ◽  
M. Gualdi ◽  
D. C. Pultrone ◽  
S. Anfuso ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Diagnostic Accuracy ◽  
Sentinel Node ◽  
Vulvar Cancer ◽  
False Negative ◽  
Case Series ◽  
Lymph Node Status ◽  
Sentinel Lymph Node Detection ◽  
Sentinel Nodes

Lymph node status is the most important prognostic factor in vulvar cancer. Histologically, sentinel nodes may be representative of the status of the other regional nodes. Identification and histopathologic evaluation of sentinel nodes could then have a significant impact on clinical management and surgery. The aim of this study was to evaluate the feasibility and diagnostic accuracy of sentinel lymph node detection by preoperative lymphoscintigraphy with technetium-99 m–labeled nanocolloid, followed by radioguided intraoperative detection. Nine patients with stage T1, N0, M0, and 11 patients with stage T2, N0, M0 squamous cell carcinoma of the vulva were included in the study. Only three cases had lesions exceeding 3.5 cm in diameter. Sentinel nodes were detected in 100% of cases. A total of 30 inguinofemoral lymphadenectomies were performed, with a mean of 10 surgically removed nodes. Histological examination revealed 17 true negative sentinel nodes, 2 true positive, and 1 false negative. In our case series, sentinel lymph node detection had a 95% diagnostic accuracy, with only one false negative. Based on literature evidence, the sentinel node procedure is feasible and reliable in vulvar cancer; however, the value of sentinel node dissection in the treatment of early-stage vulvar cancer still needs to be confirmed.

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.

Radioguided sentinel lymph node detection in vulvar cancer

2005 ◽  
Vol 15 (3) ◽  
pp. 493-497 ◽  
Author(s):  
C. Merisio ◽  
R. Berretta ◽  
M. Gualdi ◽  
D.C. Pultrone ◽  
S. Anfuso ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Vulvar Cancer ◽  
Sentinel Lymph Node Detection

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.

Morbidity and quality of life in patients with vulvar cancer after inguinal sentinel lymphadenectomy compared to radical inguinofemoral lymphadenectomy

2021 ◽  
Author(s):  
Fabinshy Thangarajah ◽  
Kristina Rogeé ◽  
Caroline Pahmeyer ◽  
Kathrin Kuhr ◽  
Matthias Schmidt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Vulvar Cancer ◽  
Lymph Node Status ◽  
P Value ◽  
Sentinel Lymphadenectomy ◽  
Significant Difference ◽  
Inguinofemoral Lymphadenectomy

Abstract Aim Probability of survival of patients with vulvar cancer directly depends on the lymph node status. Surgery of lymph nodes can be performed as radical inguinofemoral lymphadenectomy or in cases with certain conditions as sentinel lymph node surgery. The aim of this study is to obtain an overview of the intervention-related morbidity and quality of life in patients with vulvar carcinoma after lymphadenectomy. Methods Quality of life and morbidity was compared between patients who underwent radical inguinofemoral lymphadenectomy with those who underwent sentinel lymph node surgery. Results All recorded postoperative complications occur more frequently in the non-sentinel group, Significant difference was shown for the occurrence of lymphedema (p-value = 0.024) and sensitivity loss (p-value = 0.024). Recurrence of disease was more frequent in the non-sentinel group (38 % vs. 20 %, p = 0.621, n.s.) and satisfaction with groin surgery is slightly higher in the sentinel group (94 % vs. 89 %, p = 1.000, n.s.). Conclusion We could demonstrate a significantly lower morbidity of sentinel lymphadenectomy compared to conventional inguinofemoral lymphadenectomy while maintaining the same oncological safety. The low morbidity of sentinel- lymphadenectomy does not seem to influence the postoperative quality of life significantly. However, recording of the individual burden of lymphadenectomy by questionnaires should be optimized.

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

2005 ◽  
Vol 15 (2) ◽  
pp. 273-277 ◽  
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

Detection of Sentinel Nodes by Lymphoscintigraphy and Gamma Probe Guided Surgery in Vulvar Neoplasia

2000 ◽  
Vol 86 (4) ◽  
pp. 359-363 ◽  
Author(s):  
Mario Sideri ◽  
Concetta De Cicco ◽  
Angelo Maggioni ◽  
Nicoletta Colombo ◽  
Luca Bocciolone ◽  
...  
Keyword(s):  
Lymph Node ◽  
Vulvar Cancer ◽  
Gamma Probe ◽  
Human Albumin ◽  
Lymph Node Status ◽  
Breast Cancer Patients ◽  
Node Dissection ◽  
Sentinel Nodes ◽  
Guided Surgery ◽  
Pathologic Evaluation

Background Pathologic lymph node status is the most important prognostic factor in vulvar cancer; however, complete inguinofemoral node dissection is associated with significant morbidity. Intraoperative lymphoscintigraphy associated with gamma detecting probe-guided surgery has proved to be reliable in the detection of sentinel node (SN) involvement in melanoma and breast cancer patients. The present study evaluates the feasibility of the surgical identification of inguinal sentinel nodes using lymphoscintigraphy and a gamma detecting probe in patients with early vulvar cancer. Methods Technetium-99-labeled colloid human albumin was administered perilesionally in 44 patients. Twenty patients had T1 and 23 had T2 invasive epidermoid vulvar cancer; one patient had a lower-third vaginal cancer. An intraoperative gamma detecting probe was used to identify SNs during surgery. Complete inguinofemoral node dissection was subsequently performed. SNs underwent separate pathologic evaluation. Results A total of 77 groins were dissected in 44 patients. SNs were identified in all the studied groins. Thirteen cases had positive nodes: the SN was positive in all of them; in 10 cases the SN was the only positive node. Thirty-one patients showed negative SNs: all of them were negative for lymph node metastasis. Conclusions Lymphoscintigraphy and SN biopsy under gamma detecting probe guidance proved to be an easy and reliable method for detection of SNs in early vulvar cancer. If these preliminary data will be confirmed, the technique would represent a real progress towards less aggressive treatment in patients with vulvar cancer.

scholarly journals Sentinel Node Mapping for Breast Cancer: Current Situation

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sergi Vidal-Sicart ◽  
Renato Valdés Olmos
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy

Axillary node status is a major prognostic factor in early-stage disease. Traditional staging needs levels I and II axillary lymph node dissection. Axillary involvement is found in 10%–30% of patients with T1 (<2 cm) tumours. Sentinel lymph node biopsy is a minimal invasive method of checking the potential nodal involvement. It is based on the assumption of an orderly progression of lymph node invasion by metastatic cells from tumour site. Thus, when sentinel node is free of metastases the remaining nodes are free, too (with a false negative rate lesser than 5%). Moreover, Randomized trials demonstrated a marked reduction of complications associated with the sentinel lymph node biopsy when compared with axillary lymph node dissection. Currently, the sentinel node biopsy procedure is recognized as the standard treatment for stages I and II. In these stages, this approach has a positive node rate similar to those observed after lymphadenectomy, a significant decrease in morbidity and similar nodal relapse rates at 5 years. In this review, the indications and contraindications of the sentinel node biopsy are summarized and the methodological aspects discussed. Finally, the new technologic and histologic developments allow to develop a more accurate and refinate technique that can achieve virtually the identification of 100% of sentinel nodes and reduce the false negative rate.

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