This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Paramo, J. C. Articles by Mesko, T. W. Search for Related Content PubMed PubMed Citation Articles by Paramo, J. C. Articles by Mesko, T. W. Related Collections Surgery

Validation of Sentinel Node Mapping in Patients With Colon Cancer

From the Departments of Surgery (JCP, TWM) and Pathology (JS, RP), Mount Sinai Medical Center, Miami Beach, Florida.

Correspondence: Address correspondence and reprint requests to: Juan C. Paramo, MD, Department of Surgery/Section of Surgical Oncology, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140; Fax: 305-674-2863; E-mail: jcparamo{at}med411.com

Background: Sentinel lymph node (SLN) mapping techniques have been validated in breast cancer and melanoma. This study summarizes our experience with SLN mapping for colon cancer.

Methods: Fifty-five patients with colon cancer underwent intraoperative SLN mapping. One mL of 1% isosulfan blue was injected subserosally around the tumor. The first nodes highlighted with blue were identified as the SLNs. SLNs underwent multiple sectioning and immunohistochemical staining for cytokeratin. The overall learning curve was calculated.

Results: Lymphatic mapping adequately identified at least 1 SLN in 45 patients (82%). SLNs adequately predicted regional status in 44 of 45 (98%) cases. In 9 of 45 cases (20%), the SLNs were the only sites of metastases. Among the 14 cases that were SLN positive, 6 of 55 patients (11%) were positive only by immunohistochemistry. Of the 31 cases with negative SLNs, 1 case had a 3.5-mm pericolonic tumor-replaced non-SLN (3% false-negative rate). The overall learning curve stabilized after five cases.

Conclusions: Intraoperative SLN mapping is a feasible technique, with a quick learning curve, and had a reasonable SLN identification rate. Negative SLNs accurately predict the status of non-SLNs 97% of the time. Eleven percent of patients were upstaged by demonstration of micrometastases and may benefit from adjuvant chemotherapy.

Key Words: Sentinel lymph node mapping • Colon cancer • Staging • Prognosis

This article has been cited by other articles:

				R. J. de Haas, D. A. Wicherts, M. G. G. Hobbelink, I. H. M. B. Rinkes, M. E. I. Schipper, J.-A. van der Zee, and R. van Hillegersberg Sentinel Lymph Node Mapping in Colon Cancer: Current Status Ann. Surg. Oncol., March 1, 2007; 14(3): 1070 - 1080. [Abstract] [Full Text] [PDF]

				V. Lemmens, I van Lijnschoten, M. Janssen-Heijnen, H. Rutten, C. Verheij, and J-W. Coebergh Pathology practice patterns affect lymph node evaluation and outcome of colon cancer: a population-based study Ann. Onc., December 1, 2006; 17(12): 1803 - 1809. [Abstract] [Full Text] [PDF]

				A. J. Bilchik, M. DiNome, S. Saha, R. R. Turner, D. Wiese, M. McCarter, D. S. B. Hoon, and D. L. Morton Prospective Multicenter Trial of Staging Adequacy in Colon Cancer: Preliminary Results Arch Surg, June 1, 2006; 141(6): 527 - 534. [Abstract] [Full Text] [PDF]

				M. Redston, C. C. Compton, B. W. Miedema, D. Niedzwiecki, J. M. Dowell, S. D. Jewell, J. M. Fleshman, J. Bem, R. J. Mayer, and M. M. Bertagnolli Analysis of Micrometastatic Disease in Sentinel Lymph Nodes From Resectable Colon Cancer: Results of Cancer and Leukemia Group B Trial 80001 J. Clin. Oncol., February 20, 2006; 24(6): 878 - 883. [Abstract] [Full Text] [PDF]

				R. P. Sticca Is There Clinical Value to Sentinel Lymph Node Sampling in Colon Cancer? J. Clin. Oncol., February 20, 2006; 24(6): 841 - 842. [Full Text] [PDF]

				C. Codignola, F. Zorzi, A. Zaniboni, S. Mutti, A. Rizzi, E. Padolecchia, and G. B. Morandi Is there any Role for Sentinel Node Mapping in Colorectal Cancer Staging? Personal Experience and Review of the Literature Jpn. J. Clin. Oncol., November 1, 2005; 35(11): 645 - 650. [Abstract] [Full Text] [PDF]

				A. G. Dan, S. Saha, K. M. Monson, D. Wiese, E. Schochet, K. R. Barber, B. Ganatra, D. Desai, and S. Kaushal 1% Lymphazurin vs 10% Fluorescein for Sentinel Node Mapping in Colorectal Tumors Arch Surg, November 1, 2004; 139(11): 1180 - 1184. [Abstract] [Full Text] [PDF]

				F. S. Doekhie, K. C. M. J. Peeters, R. A. E. M. Tollenaar, and C. J. H. van de Velde Minimal Residual Disease Assessment in Sentinel Nodes of Breast and Gastrointestinal Cancer: A Plea for Standardization Ann. Surg. Oncol., March 1, 2004; 11(3_suppl): 236S - 241S. [Abstract] [Full Text] [PDF]

				S. Saha, A. G. Dan, A. J. Bilchik, Y. Kitagawa, E. Schochet, S. Choudhri, L. T. Saha, D. Wiese, D. Morton, and M. Kitajima Historical Review of Lymphatic Mapping in Gastrointestinal Malignancies Ann. Surg. Oncol., March 1, 2004; 11(3_suppl): 245S - 249S. [Abstract] [Full Text] [PDF]

				G Cserni Nodal staging of colorectal carcinomas and sentinel nodes J. Clin. Pathol., May 1, 2003; 56(5): 327 - 335. [Abstract] [Full Text] [PDF]

				J. W. Jakub, S. Pendas, and D. S. Reintgen Current Status of Sentinel Lymph Node Mapping and Biopsy: Facts and Controversies Oncologist, February 1, 2003; 8(1): 59 - 68. [Abstract] [Full Text] [PDF]