Detection of the sentinel lymph nodes in lung carcinoma cases using patent blue and its clinical significance

I. chirurgická klinika LF UP a FN Olomouc.
Rozhledy v chirurgii: měsíčník Československé chirurgické společnosti 07/2004; 83(6):210-6.
Source: PubMed


INTRODUCTION: Views on significance and the most appropriate approach to lymphadenectomy in the non-small-cell lung carcinoma cases, have not been consistent. The method of the sentinel lymphonode identification and biopsy, which has been verified for other tumor types, may become a promising alternative or, at least, a supplement to currently applied procedures in cases of the lung carcinoma. STUDY GROUP AND RESULTS: This prospective, non-randomized study was conducted in the Faculty Hospital in Olomouc between the years 2000-2003. The sentinel lymphonode identification was conducted in the group of 48 patients suffering from the non-small cell lung carcinoma, using the patent blue lymphatic mapping method. The sentinel lymphonode was identified in 40 patients (83.3%), a false negativity of the sentinel lymphonode was detected in 3 cases (7.5%). CONCLUSION: The study proved the clinical benefit of the sentinel lymphonode identification and biopsy method in cases of the non-small cell lung carcinoma using the patent blue dye. Under the circumstance of certain experience with the technology, the reliability of the detection approaches that of the radionuclide sentinel lymphonode detection method. However, the clinical significance of the above method must be further tested on larger patient groups.

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    • "Five studies were in Chinese [15] [16] [17] [18], 3 were in Czech [13] [43] [44], 2 were in Italian [22] [25], and the remainder were in English. Three reports were meeting abstracts [31] [33] [45]. "

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    • "Five studies were in Chinese [15] [16] [17] [18], 3 were in Czech [13] [43] [44], 2 were in Italian [22] [25], and the remainder were in English. Three reports were meeting abstracts [31] [33] [45]. "
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    ABSTRACT: Introduction: Mediastinal lymph node dissection is not necessary for all patients with NSCLC, since less than 30% of clinically stage I patients have mediastinal lymph node involvement. Sentinel node biopsy has been used for NSCLC since 1999 to decrease the need for mediastinal lymph node dissection. In the current study, we systematically searched the literature on sentinel node biopsy in NSCLC and reported the results in a systematic review and meta-analysis format. Materials and Methods: Medline, SCOPUS, and ISI web of knowledge were searched using: "(lung AND sentinel)" with no date or language limit. Any study with more than 5 patients and enough information to calculate detection rate and sensitivity were included. Results: Overall 47 and 43 studies (including subgroups) had the criteria for detection rate and sensitivity pooling respectively. Pooled detection rate was 80.6% [76.7-84%] and pooled sensitivity was 87% [83-90%]. Using radiotracers or both radiotracers and dyes had higher detection rate and sensitivity compared to dye alone. Among studies using radiotracers, peri-tumoral and pre-operative injections had higher detection rate and sensitivity compared to intra-tumoral or intra-operative injections. Un-conventional new techniques (magnetic materials, fluorescent dyes, CT contrast agents, and carbon nano-particles) had fairly high detection rate and sensitivity. Conclusions: Sentinel node mapping is a feasible and reliable technique for mediastinal lymph node staging of N0 NSCLC patients. New methods of sentinel node mapping had very promising results and warrant further studies with larger sample size.
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    ABSTRACT: Sentinel node biopsy originally developed for melanoma has gradually extended into further fields of surgical oncology. It became a standard procedure in melanoma and breast cancer, it appears to be a very helpful method in colorectal cancer. The possibilities of use are tested throughout all of surgical oncology in gastrointestinal, urological and gynecological tumors. It's importance can be displayed even in head and neck tumor, intrathoracical tumors and in thyroid cancer.
    Klinická onkologie: casopis Ceské a Slovenské onkologické spolecnosti 02/2008; 21(1):5-19.
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