scholarly journals Magnetometer-Guided Sentinel Lymph Node Dissection in Prostate Cancer: Rate of Lymph Node Involvement Compared with Radioisotope Marking

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5821
Author(s):  
Svenja Engels ◽  
Bianca Michalik ◽  
Luca-Marie Meyer ◽  
Lena Nemitz ◽  
Friedhelm Wawroschek ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Superparamagnetic Iron Oxide ◽  
Lymph Node Involvement ◽  
Nodal Staging ◽  
Node Dissection ◽  
Detection Rates ◽  
Node Involvement ◽  
Better Than

Sentinel pelvic lymph node dissection (sPLND) enables the targeted removal of lymph nodes (LNs) bearing the highest metastasis risk. In prostate cancer (PCa), sPLND alone or combined with extended PLND (ePLND) reveals more LN metastases along with detecting sentinel LNs (SLNs) outside the conventional ePLND template. To overcome the disadvantages of radioisotope-guided sPLND in PCa treatment, magnetometer-guided sPLND applying superparamagnetic iron oxide nanoparticles as a tracer was established. This retrospective study compared the nodal staging ability between magnetometer- and radioisotope-guided sPLNDs. We analyzed data of PCa patients undergoing radical prostatectomy and magnetometer- (848 patients, 2015–2021) or radioisotope-guided (2092 patients, 2006–2015) sPLND. To reduce heterogeneity among cohorts, we performed propensity score matching and compared data considering sentinel nomogram-based probabilities for LN involvement (LNI). Magnetometer- and radioisotope-guided sPLNDs had SLN detection rates of 98.12% and 98.09%, respectively; the former detected more SLNs per patient. The LNI rates matched nomogram-based predictions in both techniques equally well. Approximately 7% of LN metastases were detected outside the conventional ePLND template. Thus, we confirmed the reliability of magnetometer-guided sPLND in nodal staging, with results comparable with or better than radioisotope-guided sPLND. Our findings highlight the importance of the sentinel technique for detecting LN metastases in PCa.

P120 Lymph node involvement in prostate cancer after laparoscopic pelvic lymph node dissection

2012 ◽  
Vol 11 (5) ◽  
pp. 232
Author(s):  
V.P.M. Van Dooren ◽  
L.M.C.L. Fossion ◽  
S. Van Aarle ◽  
J.J.I. Brandenburg ◽  
E.L. Nanlohy-Manuhutu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Lymph Node Involvement ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Node Involvement

scholarly journals First Nomogram Predicting the Probability of Lymph Node Involvement in Prostate Cancer Patients Undergoing Radioisotope Guided Sentinel Lymph Node Dissection

2015 ◽  
Vol 95 (4) ◽  
pp. 422-428 ◽  
Author(s):  
Alexander Winter ◽  
Thomas Kneib ◽  
Martin Rohde ◽  
Rolf-Peter Henke ◽  
Friedhelm Wawroschek
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Predictive Accuracy ◽  
Clinical Stage ◽  
Specific Antigen ◽  
Lymph Node Involvement ◽  
High Rate ◽  
Node Dissection ◽  
Node Involvement

Introduction: Existing nomograms predicting lymph node involvement (LNI) in prostate cancer (PCa) are based on conventional lymphadenectomy. The aim of the study was to develop the first nomogram for predicting LNI in PCa patients undergoing sentinel guided pelvic lymph node dissection (sPLND). Materials and Methods: Analysis was performed on 1,296 patients with PCa who underwent radioisotope guided sPLND and retropubic radical prostatectomy (2005-2010). Median prostate specific antigen (PSA): 7.4 ng/ml (IQR 5.3-11.5 ng/ml). Clinical T-categories: T1: 54.8%, T2: 42.4%, T3: 2.8%. Biopsy Gleason sums: ≤6: 55.1%, 7: 39.5%, ≥8: 5.4%. Multivariate logistic regression models tested the association between all of the above predictors and LNI. Regression-based coefficients were used to develop a nomogram for predicting LNI. Accuracy was quantified using the area under the curve (AUC). Results: The median number of LNs removed was 10 (IQR 7-13). Overall, 17.8% of patients (n = 231) had LNI. The nomogram had a high predictive accuracy (AUC of 82%). All the variables were statistically significant multivariate predictors of LNI (p = 0.001). Univariate predictive accuracy for PSA, Gleason sum and clinical stage was 69, 75 and 69%, respectively. Conclusions: The sentinel nomogram can predict LNI at a sPLND very accurately and, for the first time, aid clinicians and patients in making important decisions on the indication of a sPLND. The high rate of LN+ patients underscores the sensitivity of sPLND.

What is the yield of regional lymph node dissection following sentinel lymph node involvement in patients with breast cancer?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10782-10782
Author(s):  
M. Ortega ◽  
M. Ruiz-Echarri ◽  
E. Prats ◽  
R. Lastra ◽  
E. Aguirre ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Dissection ◽  
Regional Lymph Node ◽  
Tumour Size ◽  
Median Number ◽  
Lymph Node Involvement ◽  
Node Dissection ◽  
Regional Lymph Node Dissection ◽  
Node Involvement

10782 Background: Sentinel lymph node is a minimally invasive and accurate staging procedure for patients with invasive breast cancer. Histological SLN involvement with cancer cells requires regional lymph node dissection. Aim: To verify if subgroups of patients with sentinel lymph node involvement in which the risk of histological involvement of additional regional lymph nodes is minimal can be identified. Methods: Ninety six consecutive patients with invasive breast cancer and tumour size less than two centimeters by mammography, had lymphoscintigraphy with colloidal 99Tc and radioisotope-guided sentinel lymph node biopsy in the University Hospital of Zaragoza from 1999 to 2005.Pathological assessment included serial sections of the sentinel lymph node with inmunohistochemistry for cytokeratins in selected cases.39 patients had histological involvement and are presented in this analysis. Results: All 39 patients were females. Median tumour size was 20 mm (range 5–52) Median number of resected sentinel lymph node was 2 (range 1–5) Median number of involved sentinel lymph node was 1 (range 1–4) Regional lymph node dissection was performed in all patients (Axillary dissection in 31; internal mammary dissection in 1, both in 7). Median number of nodes was 13 (range 2–34) At least 1 additional involved lymph node was found in 19 patients (48%) We have correlated patient age, menopausal status, pathological tumour size, histological grade, estrogen receptors, progesterone receptors and Her2 with the risk of histological lymph node involvement in regional lymph node dissection. Conclusions: Tumour size was significantly associated to such risk: No significant financial relationships to disclose.

Ugly is not only skin deep: A case of osteogenic melanoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20009-e20009
Author(s):  
Joshua C.M. Williams ◽  
Natale Tate Sheehan ◽  
Pierre DeDelva ◽  
Jennifer Barr
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Lymph Node Dissection ◽  
Lower Lobe ◽  
Lymph Node Involvement ◽  
Node Dissection ◽  
Inguinal Lymph Node Dissection ◽  
Left Lower Extremity ◽  
Node Involvement ◽  
Initial Biopsy

e20009 Background: Although the incidence of malignant melanoma is high, the incidence of metaplastic malignant melanoma is low. Within the various subtypes of malignant metaplastic melanoma, the manifestation of osteogenic melanoma remains a rarer event. Current review of the literature reveals only 12 reported cases. Of these reported cases, scant discussion is made on treatment whereas the histopathology is discussed in great detail. Methods: We present the case of a 64 year old Caucasian man that was diagnosed with synchronous tumors of the foot and lung. Initial biopsy of the foot revealed metastatic osteogenic melanoma. As a result of the initial biopsy results and imaging, the patient underwent a right lower lobe resection and lymph node dissection followed by a left lower extremity Pirigoff’s amputation and inguinal lymph node dissection. Results: Immunohistochemical staining of the extirpated tissue from the lung revealed strong reactivity to S100, vimentin, Sox10, diffuse reactivity to low molecular weight cytokeratin and HMB-45/MART-1 and no lymph node involvement. Whereas the IHC of the extirpated tissue of the left foot remained consistent with the initial biopsy of strong reactivity to S100 and MART-1 and negative to pancytokeratins, CD34, Desmin, and SMA. Conclusions: Given the features of the patient’s pathology and resected metastatic disease, he was administered adjuvant alpha interferon therapy.

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