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

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

2020 ◽  
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-minutes, 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 on clinical trials: NCT02540551 https://clinicaltrials.gov/ct2/show/NCT02540551

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.

Clinical application of the sentinel lymph node technique in early ovarian cancer: a pilot study

2018 ◽  
Vol 29 (2) ◽  
pp. 377-381 ◽  
Author(s):  
V Lago ◽  
P Bello ◽  
B Montero ◽  
L Matute ◽  
P Padilla-Iserte ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Pilot Study ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Near Infrared ◽  
Early Stage ◽  
Gamma Probe ◽  
Sentinel Lymph Nodes ◽  
Near Infrared Fluorescence Imaging

IntroductionThere is limited evidence favoring the use of the sentinel lymph node technique in ovarian cancer, and no standardized approach has been studied. The objective of the present pilot study is to determine the feasibility of the sentinel lymph node technique by applying a clinical algorithm.MethodsPatients with confirmed ovarian cancer were included. 99mTc and indocyanine green were injected into the ovarian and infundubulo-pelvic ligament stump. A gamma probe and near-infrared fluorescence imaging were used for sentinel lymph node detection.ResultsThe sentinel lymph node technique was performed in ten patients with a detection rate in the pelvic and/or para-aortic region of 100%. The tracer distribution rates of sentinel lymph nodes in the pelvic and para-aortic regions were 87.5% and 70%, respectively.ConclusionThe detection of sentinel lymph nodes in early-stage ovarian cancer appears to be achievable. Based on these results, a clinical trial entitled SENTOV (SENtinel lymph node Technique in OVarian cancer) will be performed.

Radioisotopic Lymphatic Mapping of the Sentinel Node in Melanoma: Importance of Immunohistochemistry

2000 ◽  
Vol 86 (4) ◽  
pp. 346-348 ◽  
Author(s):  
Luca Vaggelli ◽  
Antonio Castagnoli ◽  
Lorenzo Borgognoni ◽  
Carmelo Urso ◽  
Maria Matteini ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Node ◽  
Primary Tumor ◽  
Frozen Section ◽  
Gamma Probe ◽  
Lymph Node Biopsy ◽  
Pathological Examination ◽  
Blue Dye ◽  
Node Dissection ◽  
Hematoxylin Eosin

Background Elective lymph node dissection (ELND) for patients with malignant melanoma is still controversial. A possible alternative could be biopsy of the first tumor draining lymph node, the sentinel node (SN), which can be identified by means of radionuclide techniques. Aim Our study was undertaken to assess the accuracy of lymph node biopsy and to stress the importance of immunohistochemistry (IHC) in the pathological assessment of the SN for improved staging of the primary tumor. Methods We performed lymphoscintigraphy (LS) in 183 melanoma patients (89 with melanoma of the legs, 11 of the arms and 83 of the trunk). Our protocol consisted of preoperative peritumoral i.d. injection of 99mTc-labeled microcolloid to define the regional lymphatic basin and identify the sentinel node by means of planar scintigraphy. In 147 of the 183 cases a gamma probe (GP) was used during surgery to trace the SN. Vital blue dye was used during surgery in all cases. The SNs were excised for pathological examination. The pathological status of the SN was defined by means of examination of frozen sections, hematoxylin-eosin staining and immunohistochemistry for S-100 and HMB-45 MAb. Results At least one separate focus of activity was identified by LS in 182 out of 183 patients; in all 147 cases where a GP was used, it was successful in tracing the SN. LS with cutaneous mapping of the SN successfully guided the surgical excision in 177 of the 183 cases; in the 7 remaining cases, i.e. 7 out of 83 cases with SNs in the axillary basin, GP was not used and no elective node dissection was performed. Metastases were found in 39 of these 177 cases. In all 39 cases the SNs were the only positive nodes in the basin. Of the 39 metastases 18 were identified by means of frozen section, 12 by means of hematoxylin-eosin, and 9 by means of immunohistochemistry. We therefore emphasize the importance of immunohistochemistry in the pathology of LS for improved staging of the primary tumor.

scholarly journals State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

2009 ◽  
Vol 5 (5) ◽  
pp. 555-563 ◽  
Author(s):  
Jacob McGee ◽  
Allan Covens
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Early Stage ◽  
Frozen Section ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Vulvar Carcinoma ◽  
En Bloc ◽  
Node Biopsy

Treatment for early-stage vulvar carcinoma has evolved from radical en bloc dissection to wide local incision with lymphadenectomy through separate groin incisions, to sentinel lymph node biopsy (SLNB). The morbidity of SLNB is far less than traditional inguinofemoral lymphadenectomy, with less lymphedema and sensory deficit, shorter hospital stays and fewer infections. A multidisciplinary approach is required, with success of the SLNB technique maximized when radiolabeled colloid is used, with blue dye added when further identification is needed. Frozen-section analysis, followed by ultrastaging of the nodal sample, minimizes the need for reoperations and decreases the risk of false negatives. We believe that SLNB will become the standard of care for treatment of early-stage vulvar carcinoma.

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 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.

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