Sentinel node mapping for colorectal cancer with radioactive tracer

Yuukou Kitagawa, Masahiko Watanabe, Hirotoshi Hasegawa, Seiichiro Yamamoto, Hirofumi Fujii, Kentaro Yamamoto, Jun ichi Matsuda, Makio Mukai, Atsushi Kubo, Masaki Kitajima

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

PURPOSE: The aim of this study was to test the feasibility and accuracy of radioactivity-guided mapping of the first lymph nodes found in draining the primary tumor site for colorectal cancer. METHODS: We enrolled 56 consecutive patients with preoperative diagnosis of curatively resectable colorectal cancer. Endoscopic injection of technetium Tc 99m-labeled tin colloid (15 MBq) was performed preoperatively, and radioactive sentinel nodes were identified intraoperatively with a gamma probe. Standard radical resection with lymph node dissection was performed in all patients, and all resected nodes were evaluated by routine histopathologic examination. RESULTS: Radioactivity-guided methods were used to detect sentinel nodes in 51 (91 percent) of 56 patients. The number of lymph nodes resected was 23.9 ± 15.2 per case. The number of sentinel nodes was 3.5 ± 2.1 (range, 0-8) per case. In 18 of 22 patients with lymph node metastasis, the sentinel node was positive. The incidence of metastasis in the sentinel node (22 percent) was significantly higher than that in nonsentinel nodes (3 percent, P < 0.01). Diagnostic accuracy according to sentinel node status was 92 percent (47/51). Four false-negative cases in this study were advanced cases with T3 primary tumors. The detection rate and diagnostic accuracy for patients with T1 or T2 primary tumors (29 cases) were 100 percent each. CONCLUSION: Intraoperative radioactivity-guided sentinel node mapping was accurate for patients with colorectal cancer with T1 or T2 tumors. The results suggest that sentinel node mapping and intraoperative biopsy may be a sensitive and specific diagnostic method for detecting metastasis in regional lymph nodes in patients with colorectal cancer.

Original languageEnglish
Pages (from-to)1476-1480
Number of pages5
JournalDiseases of the Colon and Rectum
Volume45
Issue number11
DOIs
Publication statusPublished - 2002 Nov 1

Fingerprint

Radioactive Tracers
Colorectal Neoplasms
Radioactivity
Lymph Nodes
Neoplasm Metastasis
Neoplasms
cyhalothrin
Lymph Node Excision
Biopsy
Injections
Incidence

Keywords

  • Colorectal cancer
  • Radioactive tracer
  • Sentinel node

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kitagawa, Y., Watanabe, M., Hasegawa, H., Yamamoto, S., Fujii, H., Yamamoto, K., ... Kitajima, M. (2002). Sentinel node mapping for colorectal cancer with radioactive tracer. Diseases of the Colon and Rectum, 45(11), 1476-1480. https://doi.org/10.1007/s10350-004-6453-0

Sentinel node mapping for colorectal cancer with radioactive tracer. / Kitagawa, Yuukou; Watanabe, Masahiko; Hasegawa, Hirotoshi; Yamamoto, Seiichiro; Fujii, Hirofumi; Yamamoto, Kentaro; Matsuda, Jun ichi; Mukai, Makio; Kubo, Atsushi; Kitajima, Masaki.

In: Diseases of the Colon and Rectum, Vol. 45, No. 11, 01.11.2002, p. 1476-1480.

Research output: Contribution to journalArticle

Kitagawa, Y, Watanabe, M, Hasegawa, H, Yamamoto, S, Fujii, H, Yamamoto, K, Matsuda, JI, Mukai, M, Kubo, A & Kitajima, M 2002, 'Sentinel node mapping for colorectal cancer with radioactive tracer', Diseases of the Colon and Rectum, vol. 45, no. 11, pp. 1476-1480. https://doi.org/10.1007/s10350-004-6453-0
Kitagawa, Yuukou ; Watanabe, Masahiko ; Hasegawa, Hirotoshi ; Yamamoto, Seiichiro ; Fujii, Hirofumi ; Yamamoto, Kentaro ; Matsuda, Jun ichi ; Mukai, Makio ; Kubo, Atsushi ; Kitajima, Masaki. / Sentinel node mapping for colorectal cancer with radioactive tracer. In: Diseases of the Colon and Rectum. 2002 ; Vol. 45, No. 11. pp. 1476-1480.
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AU - Yamamoto, Kentaro

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N2 - PURPOSE: The aim of this study was to test the feasibility and accuracy of radioactivity-guided mapping of the first lymph nodes found in draining the primary tumor site for colorectal cancer. METHODS: We enrolled 56 consecutive patients with preoperative diagnosis of curatively resectable colorectal cancer. Endoscopic injection of technetium Tc 99m-labeled tin colloid (15 MBq) was performed preoperatively, and radioactive sentinel nodes were identified intraoperatively with a gamma probe. Standard radical resection with lymph node dissection was performed in all patients, and all resected nodes were evaluated by routine histopathologic examination. RESULTS: Radioactivity-guided methods were used to detect sentinel nodes in 51 (91 percent) of 56 patients. The number of lymph nodes resected was 23.9 ± 15.2 per case. The number of sentinel nodes was 3.5 ± 2.1 (range, 0-8) per case. In 18 of 22 patients with lymph node metastasis, the sentinel node was positive. The incidence of metastasis in the sentinel node (22 percent) was significantly higher than that in nonsentinel nodes (3 percent, P < 0.01). Diagnostic accuracy according to sentinel node status was 92 percent (47/51). Four false-negative cases in this study were advanced cases with T3 primary tumors. The detection rate and diagnostic accuracy for patients with T1 or T2 primary tumors (29 cases) were 100 percent each. CONCLUSION: Intraoperative radioactivity-guided sentinel node mapping was accurate for patients with colorectal cancer with T1 or T2 tumors. The results suggest that sentinel node mapping and intraoperative biopsy may be a sensitive and specific diagnostic method for detecting metastasis in regional lymph nodes in patients with colorectal cancer.

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