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01-03-2011

Feasibility study of sentinel lymph node biopsy in esophageal cancer with conservative lymphadenectomy

Authors: Sarah K. Thompson, Dylan Bartholomeusz, Peter G. Devitt, Peter J. Lamb, Andrew R. Ruszkiewicz, Glyn G. Jamieson

Published in: Surgical Endoscopy | Issue 3/2011

Abstract

Introduction

Lymphoscintigraphy and sentinel node mapping is established in breast cancer and melanoma but not in esophageal cancer, even though many centers have shown that occult tumor deposits in lymph nodes influence prognosis. We report our initial experience with lymphoscintigraphy and sentinel lymph node biopsy in patients undergoing resection for esophageal cancer.

Methods

Sixteen of 17 consecutive patients underwent resection for invasive esophageal cancer along with sentinel lymph node retrieval (resection rate, 94%). Peritumoral injection of ^99mTc antimony colloid was performed by upper endoscopy prior to the operation. A two-surgeon synchronous approach via right thoracotomy and laparotomy was performed with conservative lymphadenectomy. Sentinel lymph nodes were identified using a gamma probe both in vivo and ex vivo. Sentinel lymph nodes were sent off separately for serial sections and immunohistochemistry.

Results

Median patient age was 60.4 years (range, 45–75 years). Fifteen were male, and thirteen had adenocarcinoma. At least one sentinel lymph node (median, 2) was identified in 14 of 16 patients (success rate, 88%). Sentinel nodes were present in more than one nodal station in five patients (31%). In all 14 patients, the sentinel lymph node accurately predicted findings in non-sentinel nodes (accuracy, 100%). Three patients with positive sentinel lymph nodes had metastases identified in non-sentinel nodes (sensitivity, 100%).

Conclusions

Sentinel lymph node biopsy is feasible in esophageal resection with conservative lymphadenectomy, and initial results suggest it is accurate in predicting overall nodal status. Further study is needed to assess impact on patient management and prognosis.

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Title: Feasibility study of sentinel lymph node biopsy in esophageal cancer with conservative lymphadenectomy
Authors: Sarah K. Thompson
Dylan Bartholomeusz
Peter G. Devitt
Peter J. Lamb
Andrew R. Ruszkiewicz
Glyn G. Jamieson
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 3/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-010-1265-x

At a glance: The STEP trials

Springer Medicine

Feasibility study of sentinel lymph node biopsy in esophageal cancer with conservative lymphadenectomy

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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