Sentinel node in colon cancer: a multimodal approach
© Palmisano et al; licensee BioMed Central Ltd. 2009
Published: 1 April 2009
Colon cancer staging and prognosis are factors related to nodal status. About 15–20% stage I or II patients develop local recurrences and distant metastases within 5 years despite surgery with curative intent. Sentinel lymph node mapping aims to facilitate staging, to identify any unusual mesenteric lymphatic drainage patterns and to select patients who might benefit from adjuvant chemotherapy.
Materials and methods
Criteria of the study
Synchronous colon cancer
Previous colon resections
Pathological colon polyps
Patients without metastases
Preoperative pathological nodes
Adverse reaction to the colorant
Neurological or psychiatric disease
Detection rate was 90.9%. A mean of 2 sentinel nodes per patient was found. Mean lymph node mapping time was 15 minutes. One case of false negative was discovered. The sensitivity of the multilevel sectioning and immunohistochemistry was 75%; the negative predictive value was 95%. Neither skip metastases nor aberrant drainage were found.
Intraoperative sentinel lymph node mapping is a feasible technique. Cooperation between gastroenterologists, surgeons, anatomopathologists and oncologists are necessary to achieve a correct procedure. Histological upstaging is effective and reliable to define node status and consequently tumour staging and prognosis.
This article is published under license to BioMed Central Ltd.