scholarly journals Lymphoscintigraphy in Detection of the Regional Lymph Node Involvement in Gastric Cancer

2006 ◽  
Vol 88 (7) ◽  
pp. 632-638 ◽  
Author(s):  
M Mahir Ozmen ◽  
Baris Zulfikaroglu ◽  
N Ozlem Kucuk ◽  
Necdet Ozalp ◽  
Gulseren Aras ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Lymph Node Involvement ◽  
Regional Lymph Nodes ◽  
Abdominal Ultrasonography ◽  
Regional Lymph Node Involvement ◽  
Node Involvement

INTRODUCTION Involvement of regional lymph node is a critical sign in prognosis of gastric cancer. Radiological techniques are commonly used to evaluate the extension of gastric cancer. But their sensitivity and specificity are low especially in the early stage. Our aim was to assess the value of gastric lymphoscintigraphy in identifying regional lymph node involvement in patients with gastric cancer, as compared to the abdominal ultrasonography, computed tomography and postoperative histopathological evaluation. PATIENTS AND METHODS 50 patients (12 females) with a median age of 61 years (range, 35–73 years) were included in the study. Pre-operative staging in all cases included upper gastrointestinal endoscopy and biopsy, followed by ultrasound, computed tomography and lymphoscintigraphy. 148 MBq Technetium-99m lymphoscint was injected around the tumour during endoscopy and immediately after injection, anterior, lateral and posterior images were taken in 5-min intervals using a gamma camera. Findings were compared to the findings of other tests. The sensitivity, specificity, positive predictive value, and negative predictive value of each test were calculated and compared. RESULTS Histologically, 68% of cases (34/50) had metastasis in regional lymph nodes and all cases were accurately diagnosed by lymphoscintigraphy. Lymphoscintigraphy was significantly more sensitive for detecting lymph node involvement (P < 0.01). Both abdominal ultrasonography and CT had very low sensitivity in identifying lymph nodes. CONCLUSIONS Lymphoscintigraphy is a promising test in the identification of regional lymph nodes pre-operatively in patients with gastric cancer. It might help the surgeon to plan the extent of dissection before surgery which may decrease postoperative complications related to unnecessary extensive lymph node dissection.

scholarly journals Prognostic Factors of Lymph Nodes in Colorectal Carcinoma

2020 ◽  
Vol 17 (5) ◽  
pp. 7-14
Author(s):  
Marilena Stoian ◽  
Lucia Indrei ◽  
Victor Stoica
Keyword(s):  
Lymph Node ◽  
Colorectal Carcinoma ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Regional Lymph Node ◽  
Laboratory Data ◽  
Lymph Node Involvement ◽  
Acceptable Error ◽  
Regional Lymph Node Involvement ◽  
Node Involvement

Abstract Background/Aims. The aim of this study was to establish whether, and to what extent, preand intraoperatively detected characteristics (demographic, anamnestic and laboratory data) and tumor characteristics can be used in the assessment of regional lymph node involvement in patients with colorectal carcinoma. The assessment also included the number of lymph nodes involved in patients with positive lymph nodes. Considering that the number of obtained lymph nodes is resected specimens, assessment parameters also included the percentage of the involved lymph nodes within the total population of lymph nodes. Methodology. From 2010-2019, 46 patients with carcinoma of the rectum and sigmoid colon were studied, with a total number of 736 lymph nodes evaluated. Out of the total number of lymph nodes, 577 (78.4%) were benign and 159 (21.6%), malignant. Data were analyzed by multi-variant statistical methods: discriminant analysis and multiple regression. Results. For this patient group, we evaluated the following potentially predictive factors for lymph node involvement: age; serum hemoglobin, albumin and alkaline phosphatase levels; weight loss; and the primary tumor localization characteristics: histological type, macroscopic growth pattern and depth of tumor invasion of the bowel wall. We found that there was no difference in the prediction of regional lymph node involvement between analysis of the aforementioned parameters and analysis of the isolated discriminators only. Conclusion. A predictability likelihood of 83.78% greatly surpasses the acceptable error tolerance level of 5%. Correlation of demographic, anamnestic and laboratory data about the patient and the characteristics of the primary tumor cannot be used in distinguishing malignant lymph nodes from benign ones. These data cannot be the basis for exact intraoperative staging and thus cannot be significant criteria foe decision-making about operative treatment modalities.

scholarly journals Computed tomography–based distribution of involved lymph nodes in patients with upper esophageal cancer

2015 ◽  
Vol 22 (3) ◽  
pp. 178 ◽  
Author(s):  
M. Li ◽  
Y. Liu ◽  
L. Xu ◽  
Y. Huang ◽  
W. Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Metastatic Lymph Node ◽  
Radiation Therapy Oncology Group ◽  
Lymph Node Involvement ◽  
Specific Distribution ◽  
Node Involvement ◽  
Upper Thoracic

BackgroundDelineating the nodal clinical target volume (ctvn) remains a challenging task in patients with cervical or upper thoracic esophageal carcinoma (ec). In particular, the extent of the lymph area that should be included in the irradiation field remains controversial. In the present study, the extent of the ctvn was determined based on the incidence of lymph node involvement mapped by computed tomography (ct) imaging.Methods Our study included 468 patients who were diagnosed with cervical and upper thoracic ec and who received staging information between June 2005 and April 2011. The anatomic distribution of metastatic regional lymph nodes was mapped using ct images and grouped using the levels established by the Radiation Therapy Oncology Group. The probability of the various groups being involved was examined. If a lymph node group had a probability of 10% or more of being involved, it was considered at high risk for metastasis, and elective treatment as part of the ctvn was recommended.Results Lymph node involvement was mapped by ct in 256 patients (54.7%). Not all lymph node groups should be included in the ctvn. For cervical lesions, the involved lymph nodes were located mainly between the hyoid bone and the arcus aortae; the recommended ctvn should consist of the neck lymph nodes at levels iii and iv (supraclavicular group) and thoracic groups 2 and 3P. In upper thoracic ec patients, most of the involved lymph nodes were distributed between the cricoid cartilage and the subcarinal area; the ctvn should cover the supraclavicular group and thoracic nodal groups 2, 3P, 4, 5, and 7.Conclusions Our ct-based study indicates a specific distribution and incidence of metastatic lymph node groups in patients with cervical and upper thoracic ec. The results suggest that regional lymph node groups should be electively included in the ctvn for precise radiation administration.

scholarly journals Significance of ipsilateral lobar lymph node dissection in the surgical treatment of non-small cell lung cancer with regional lymph node involvement

2017 ◽  
Vol 98 (1) ◽  
pp. 137-140
Author(s):  
A F Gil’metdinov ◽  
V P Potanin
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Regional Lymph Node ◽  
Lymph Node Involvement ◽  
Lymph Node Status ◽  
Node Dissection ◽  
Small Cell Lung ◽  
Regional Lymph Node Involvement ◽  
Node Involvement

Aim. Analysis of significance of ipsilateral lobar lymph node dissection in the surgical treatment of non-small cell lung cancer with regional lymph node involvement.Methods. We have analyzed medical records of inpatients and outpatients observed in Republican Clinical Oncology Dispensary of Tatarstan Ministry of Healthcare and operated in 2000-2009. Patients were divided into the groups according to the stage (IB, IIB, IIIA), clinical and anatomic form (peripheral or central cancer), volume of surgery (lobectomy and pulmonectomy) and degree of primary tumor spread and lymph node involvement according to TxNx (T2N0, T2N1, T3N0, T2N2). Total of 803 patients were included. Five-year survival rate in each group was counted by the method of Kaplan-Meier based on volume of surgery (lobectomy and pulmonectomy) and lymph node status (N1, N2).Results. In peripheral cancer with regional lymph nodes status N1-2 pulmonectomy with removal of ipsilateral lobar lymph nodes is associated with low survival. In central cancer regional lymph node status change from N0 to N1 does not influence survival after lobectomy/pulmonectomy indicating the positive effect of removal of ipsilateral lobar lymph nodes on survival in this group of patients. In central cancer with N2 survival after pulmonectomy decreases by 2 times indicating no influence of removal of ipsilateral lobar lymph nodes on survival in this group of patients.Conclusion. In peripheral cancer with morphologic confirmation of regional lymph node involvement N1-2, as well as in central cancer with morphologic confirmation of regional lymph node involvement N2, ipsilateral lobar lymph node dissection is irrational; in all other cases (central cancer N0-1 or peripheral cancer N0) ipsilateral lobar lymph node dissection is rational.

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