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10.1245/s10434-006-9258-7
Annals of Surgical Oncology 14:1070-1080 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

Robbert J. de Haas1, Dennis A. Wicherts1, Monique G. G. Hobbelink, MD2, Inne H. M. Borel Rinkes, MD, PhD1, Marguerite E. I. Schipper, MD3, Joke-Afke van der Zee, MD1 and Richard van Hillegersberg, MD, PhD1

1 Department of Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
2 Department of Nuclear Medicine, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
3 Department of Pathology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands

Correspondence: Address correspondence and reprint requests to: Richard van Hillegersberg, MD, PhD; E-mail: R.vanHillegersberg{at}chir.azu.nl

Background: The primary role of sentinel lymph node (SLN) mapping in colon cancer is to increase the accuracy of nodal staging by identifying those lymph nodes with the greatest potential for harbouring metastatic disease. Ultrastaging techniques aim to identify the otherwise undetected metastases. Until now, no consensus exists as to the most optimal procedure in patients with colon cancer.

Methods: A systematic literature search on the value of different SLN mapping techniques in patients with colon cancer was performed using the electronic search engine PubMed. Prospective studies published before 1 December 2005 were included and further articles were selected by cross-referencing. The results of different techniques using either blue dye or radiocolloid, were investigated.

Results: The literature search yielded 17 relevant articles. SLN mapping using blue dye was described in 15 studies. Two studies reported the results of SLN mapping using a combination of blue dye and radiocolloid. The reported results on identification rate varied between 71 and 100%. Accuracy rates were between 78 and 100%, sensitivity rates between 25 and 100% and true upstaging rates between 0 and 26%. The results were not affected by the addition of radiocolloid to blue dye.

Conclusions: Sentinel lymph node mapping in patients with colon cancer remains an experimental procedure with varying results. Further evaluation may lead to a standardized technique that offers the potential for significant upstaging of stage II patients. This may have important implications as to tailor adjuvant chemotherapeutic regimens in these patients.

Key Words: Sentinel lymph node mapping • Colon cancer • Micrometastasis




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