In vivo and ex vivo sentinel node mapping does not identify the same lymph nodes in colon cancer

TY - JOUR

T1 - In vivo and ex vivo sentinel node mapping does not identify the same lymph nodes in colon cancer

AU - Andersen, Helene Schou

AU - Bennedsen, Astrid Louise Bjørn

AU - Burgdorf, Stefan Kobbelgaard

AU - Eriksen, Jens Ravn

AU - Eiholm, Susanne

AU - Toxværd, Anders

AU - Riis, Lene Buhl

AU - Rosenberg, Jacob

AU - Gögenur, Ismail

PY - 2017/7/1

Y1 - 2017/7/1

N2 - INTRODUCTION: Identification of lymph nodes and pathological analysis is crucial for the correct staging of colon cancer. Lymph nodes that drain directly from the tumor area are called "sentinel nodes" and are believed to be the first place for metastasis. The purpose of this study was to perform sentinel node mapping in vivo with indocyanine green and ex vivo with methylene blue in order to evaluate if the sentinel lymph nodes can be identified by both techniques.METHODS: Patients with colon cancer UICC stage I-III were included from two institutions in Denmark from February 2015 to January 2016. In vivo sentinel node mapping with indocyanine green during laparoscopy and ex vivo sentinel node mapping with methylene blue were performed in all patients.RESULTS: Twenty-nine patients were included. The in vivo sentinel node mapping was successful in 19 cases, and ex vivo sentinel node mapping was successful in 13 cases. In seven cases, no sentinel nodes were identified. A total of 51 sentinel nodes were identified, only one of these where identified by both techniques (2.0%). In vivo sentinel node mapping identified 32 sentinel nodes, while 20 sentinel nodes were identified by ex vivo sentinel node mapping. Lymph node metastases were found in 10 patients, and only two had metastases in a sentinel node.CONCLUSION: Placing a deposit in relation to the tumor by indocyanine green in vivo or of methylene blue ex vivo could only identify sentinel lymph nodes in a small group of patients.

AB - INTRODUCTION: Identification of lymph nodes and pathological analysis is crucial for the correct staging of colon cancer. Lymph nodes that drain directly from the tumor area are called "sentinel nodes" and are believed to be the first place for metastasis. The purpose of this study was to perform sentinel node mapping in vivo with indocyanine green and ex vivo with methylene blue in order to evaluate if the sentinel lymph nodes can be identified by both techniques.METHODS: Patients with colon cancer UICC stage I-III were included from two institutions in Denmark from February 2015 to January 2016. In vivo sentinel node mapping with indocyanine green during laparoscopy and ex vivo sentinel node mapping with methylene blue were performed in all patients.RESULTS: Twenty-nine patients were included. The in vivo sentinel node mapping was successful in 19 cases, and ex vivo sentinel node mapping was successful in 13 cases. In seven cases, no sentinel nodes were identified. A total of 51 sentinel nodes were identified, only one of these where identified by both techniques (2.0%). In vivo sentinel node mapping identified 32 sentinel nodes, while 20 sentinel nodes were identified by ex vivo sentinel node mapping. Lymph node metastases were found in 10 patients, and only two had metastases in a sentinel node.CONCLUSION: Placing a deposit in relation to the tumor by indocyanine green in vivo or of methylene blue ex vivo could only identify sentinel lymph nodes in a small group of patients.

KW - Adult

KW - Aged

KW - Colonic Neoplasms/pathology

KW - Demography

KW - Dissection

KW - Female

KW - Humans

KW - Lymph Nodes/pathology

KW - Male

KW - Middle Aged

KW - Sentinel Lymph Node Biopsy/methods

U2 - 10.1007/s00384-017-2777-9

DO - 10.1007/s00384-017-2777-9

M3 - Journal article

C2 - 28210851

SN - 0179-1958

VL - 32

SP - 983

EP - 990

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

IS - 7

ER -