Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease.
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease. ">
[PDF] Erken evre küçük hücreli dışı akciğer kanserinde sentinel lenf nodu haritalaması | [PDF] Sentinel lymph node mapping in early stage non-small cell lung carcinoma
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease. ">
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease.
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease. ">
Erken evre küçük hücreli dışı akciğer kanserinde sentinel lenf nodu haritalaması
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease.
Sentinel lymph node mapping in early stage non-small cell lung carcinoma
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC). Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease.
1) Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin 2009;59:225-49. doi:10.3322/caac.20006.
2) Izbicki JR, Passlick B, Pantel K, Pichlmeier U, Hosch SB, Karg O, et al. Effectiveness of radical systematic mediastinal lymphadenectomy in patients with resectable non-small cell lung cancer: results of a prospective randomized trial. Ann Surg 1998;227:138-44.
3) Wu Yl, Huang ZF, Wang SY, Yang XN, Ou W. A randomized trial of systematic nodal dissection in resectable non-small cell lung cancer. Lung Cancer 2002;36:1-6.
4) Rami-Porta R, Wittekind C, Goldstraw P; International Association for the Study of Lung Cancer (IASLC) Staging Committee. Complete resection in lung cancer surgery: proposed definition. Lung Cancer 2005;49:25-33.
5) Mountain CF. Revisions in the International System for Staging Lung Cancer. Chest 1997;111:1710-7.
6) Tiffet O, Perrot JL, Soler C, Cambazard F, Dubois F, Seguin P, et al. Detection of lymphatic metastasis from malignant melanoma after identification of the sentinel node by preoperative lymphoscintigraphy and intraoperative radioisotopic detection. Ann Chir 2000;125:32-9. [Abstract]
7) Vogt H, Schmidt M, Bares R, Brenner W, Grünwald F, Kopp J, et al. Procedure guideline for sentinel lymph node diagnosis. Nuklearmedizin 2010;49:167-72; quiz N19. doi:10.3413/nukmed-321. Epub 2010. [Abstract]
8) Rena O, Carsana L, Cristina S, Papalia E, Massera F, Errico L, et al. Lymph node isolated tumor cells and micrometastases in pathological stage I non-small cell lung cancer: prognostic significance. Eur J Cardiothorac Surg 2007;32:863-7.
9) Liptay MJ. Sentinel node mapping in lung cancer. Ann Surg Oncol 2004;11:271S-4S.
10) Atinkaya C, Ozlem Küçük N, Koparal H, Aras G, Sak SD, Ozdemir N. Mediastinal intraoperative radioisotope sentinel lymph node mapping in non-small-cell lung cancer. Nucl Med Commun 2005;26:717-20.
11) Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2007;2:706-14.
12) Tanita T, Hoshikawa Y, Tabata T, Noda M, Handa M, Kubo H, et al. Functional evaluations for pulmonary resection for lung cancer in octogenarians. Investigation from postoperative complications. Jpn J Thorac Cardiovasc Surg 1999;47:253-61.
13) Bollen EC, van Duin CJ, Theunissen PH, vt Hof-Grootenboer BE, Blijham GH. Mediastinal lymph node dissection in resected lung cancer: morbidity and accuracy of staging. Ann Thorac Surg 1993;55:961-6.
14) Little AG, DeHoyos A, Kirgan DM, Arcomano TR, Murray KD. Intraoperative lymphatic mapping for non-small cell lung cancer: the sentinel node technique. J Thorac Cardiovasc Surg 1999;117:220-4.
15) Liptay MJ, Masters GA, Winchester DJ, Edelman BL, Garrido BJ, Hirschtritt TR, et al. Intraoperative radioisotope sentinel lymph node mapping in non-small cell lung cancer. Ann Thorac Surg 2000;70:384-9.
16) Kim S, Kim HK, Kang DY, Jeong JM, Choi YH. Intraoperative sentinel lymph node identification using a novel receptor-binding agent (technetium-99m neomannosyl human serum albumin, 99mTc-MSA) in stage I non-small cell lung cancer. Eur J Cardiothorac Surg 2010;37:1450-6. doi: 10.1016/j.ejcts.2010.01.012.
17) Dobashi K, Sugio K, Osaki T, Oka T, Yasumoto K. Micrometastatic P53-positive cells in the lymph nodes of non-small-cell lung cancer: prognostic significance. J Thorac Cardiovasc Surg 1997;114:339-46.
18) Kubuschok B, Passlick B, Izbicki JR, Thetter O, Pantel K. Disseminated tumor cells in lymph nodes as a determinant for survival in surgically resected non-small-cell lung cancer. J Clin Oncol 1999;17:19-24.
19) Izbicki JR, Passlick B, Hosch SB, Kubuschock B, Schneider C, Busch C, et al. Mode of spread in the early phase of lymphatic metastasis in non-small-cell lung cancer: significance of nodal micrometastasis. J Thorac Cardiovasc Surg 1996;112:623-30.
20) Jiao X, Krasna MJ. Clinical significance of micrometastasis in lung and esophageal cancer: a new paradigm in thoracic oncology. Ann Thorac Surg 2002;74:278-84.
21) Liptay MJ, Grondin SC, Fry WA, Pozdol C, Carson D, Knop C, et al. Intraoperative sentinel lymph node mapping in nonsmall- cell lung cancer improves detection of micrometastases. J Clin Oncol 2002;20:1984-8.
22) Melfi FM, Chella A, Menconi GF, Givigliano F, Boni G, Mariani G, et al. Intraoperative radioguided sentinel lymph node biopsy in non-small cell lung cancer. Eur J Cardiothorac Surg 2003;23:214-20.
23) Melfi FM, Lucchi M, Davini F, Viti A, Fontanini G, Boldrini L, et al. Intraoperative sentinel lymph node mapping in stage I non-small cell lung cancer: detection of micrometastases by polymerase chain reaction. Eur J Cardiothorac Surg 2008;34:181-6. doi: 10.1016/j.ejcts.2008.03.059.
24) Nomori H, Horio H, Naruke T, Orikasa H, Yamazaki K, Suemasu K. Use of technetium-99m tin colloid for sentinel lymph node identification in non-small cell lung cancer. J Thorac Cardiovasc Surg 2002;124:486-92.
25) Rzyman W, Hagen OM, Dziadziuszko R, Kobierska-Gulida G, Karmolinski A, Lothe IM, et al. Intraoperative, radioguided sentinel lymph node mapping in 110 nonsmall cell lung cancer patients. Ann Thorac Surg 2006;82:237-42.
26) Nohl-Oser HC. An investigation of the anatomy of the lymphatic drainage of the lungs as shown by the lymphatic spread of bronchial carcinoma. Ann R Coll Surg Engl 1972;51:157-76.