Skip to main content
Top
Published in: World Journal of Surgery 3/2006

01-03-2006

Carbon Dye Staining of Sentinel Lymph Nodes Facilitates Microstaging of Colon Cancer Patients

Authors: Carsten T. Viehl, MD, Ulrich Guller, MD, MHS, Christian T. Hamel, MD, Hans-Martin Riehle, MD, Christian Plaass, MD, Walter R. Marti, MD, Daniel Oertli, MD, Markus Zuber, MD

Published in: World Journal of Surgery | Issue 3/2006

Login to get access

Abstract

Background

Carbon dye, when peritumourally injected, permanently marks the drainage site of sentinel lymph nodes (SLN). The objective of the current study was to evaluate whether the use of carbon dye facilitated the detection of small nodal tumour infiltrates in colon cancer patients.

Methods

In a prospective trial, 19 patients underwent open, oncological resections of localized colon cancer and SLN procedure according to a standardized protocol. Isosulfan blue 1% and sterile filtered carbon dye (mixed 1:1) were injected into the subserosa circumferentially around the tumour. Lymph nodes staining blue were marked as SLN. Serial sections of each SLN were stained with hematoxylin and eosin (H&E) and with the pancytokeratin marker AE1/AE3. The intranodal presence and site of carbon particles were noted and compared with the location of possible tumour infiltrates.

Results

Identification of at least one SLN was successful in 18 patients (identification rate 95%). Four patients (22%) were pN+, 11 (61%) were pN0(i−). Three patients (17%) were upstaged from pN0(i−) to pN0(i+) as isolated tumour cells were detected in their SLN: in two (11%) of the three patients, carbon dye and isolated tumour cells were found in the same nodal compartment, hence facilitating the recognition of isolated tumour cells by the pathologist.

Conclusion

The use of carbon dye in the SLN procedure for colon cancer may facilitate the detection of small nodal tumour infiltrates.
Literature
1.
go back to reference Greenson JK, Isenhart CE, Rice R, et al. Identification of occult micrometastases in pericolic lymph nodes of Duke’s B colorectal cancer patients using monoclonal antibodies against cytokeratin and CC49. Correlation with long-term survival. Cancer 1994;73:563–569PubMed Greenson JK, Isenhart CE, Rice R, et al. Identification of occult micrometastases in pericolic lymph nodes of Duke’s B colorectal cancer patients using monoclonal antibodies against cytokeratin and CC49. Correlation with long-term survival. Cancer 1994;73:563–569PubMed
2.
go back to reference Liefers GJ, Cleton-Jansen AM, van de Velde CJ, et al. Micrometastases and survival in stage II colorectal cancer. N Engl J Med 1998;339:223–228CrossRefPubMed Liefers GJ, Cleton-Jansen AM, van de Velde CJ, et al. Micrometastases and survival in stage II colorectal cancer. N Engl J Med 1998;339:223–228CrossRefPubMed
3.
go back to reference Saha S, Bilchik A, Wiese D, et al. Ultrastaging of colorectal cancer by sentinel lymph node mapping technique – a multicenter trial. Ann Surg Oncol 2001;8:94S–98SPubMed Saha S, Bilchik A, Wiese D, et al. Ultrastaging of colorectal cancer by sentinel lymph node mapping technique – a multicenter trial. Ann Surg Oncol 2001;8:94S–98SPubMed
4.
go back to reference Haigh PI, Lucci A, Turner RR, et al. Carbon dye histologically confirms the identity of sentinel lymph nodes in cutaneous melanoma. Cancer 2001;92:535–541CrossRefPubMed Haigh PI, Lucci A, Turner RR, et al. Carbon dye histologically confirms the identity of sentinel lymph nodes in cutaneous melanoma. Cancer 2001;92:535–541CrossRefPubMed
5.
go back to reference Morton DL, Hoon DS, Cochran AJ, et al. Lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: therapeutic utility and implications of nodal microanatomy and molecular staging for improving the accuracy of detection of nodal micrometastases. Ann Surg 2003;238:538–549PubMed Morton DL, Hoon DS, Cochran AJ, et al. Lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: therapeutic utility and implications of nodal microanatomy and molecular staging for improving the accuracy of detection of nodal micrometastases. Ann Surg 2003;238:538–549PubMed
6.
go back to reference Viehl CT, Hamel CT, Marti WR, et al. Identification of sentinel lymph nodes in colon cancer depends on the amount of dye injected relative to tumor size. World J Surg 2003;27:1285–1290CrossRefPubMed Viehl CT, Hamel CT, Marti WR, et al. Identification of sentinel lymph nodes in colon cancer depends on the amount of dye injected relative to tumor size. World J Surg 2003;27:1285–1290CrossRefPubMed
7.
go back to reference Sobin LH, Wittekind C. TNM Classification of malignant tumours. 6th edn. Wiley, New York, 2002 Sobin LH, Wittekind C. TNM Classification of malignant tumours. 6th edn. Wiley, New York, 2002
8.
go back to reference Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392–399PubMed Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392–399PubMed
9.
go back to reference Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994;220:391–398PubMed Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994;220:391–398PubMed
10.
go back to reference Giuliano AE, Dale PS, Turner RR, et al. Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg 1995;222:394–399PubMed Giuliano AE, Dale PS, Turner RR, et al. Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg 1995;222:394–399PubMed
11.
go back to reference Joosten JJ, Strobbe LJ, Wauters CA, et al. Intraoperative lymphatic mapping and the sentinel node concept in colorectal carcinoma. Br J Surg 1999;86:482–486CrossRefPubMed Joosten JJ, Strobbe LJ, Wauters CA, et al. Intraoperative lymphatic mapping and the sentinel node concept in colorectal carcinoma. Br J Surg 1999;86:482–486CrossRefPubMed
12.
go back to reference Saha S, Wiese D, Badin J, et al. Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging. Ann Surg Oncol 2000;7:120–124CrossRefPubMed Saha S, Wiese D, Badin J, et al. Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging. Ann Surg Oncol 2000;7:120–124CrossRefPubMed
13.
go back to reference Feezor RJ, Copeland EM III, Hochwald SN. Significance of micrometastases in colorectal cancer. Ann Surg Oncol 2002;9:944–953CrossRefPubMed Feezor RJ, Copeland EM III, Hochwald SN. Significance of micrometastases in colorectal cancer. Ann Surg Oncol 2002;9:944–953CrossRefPubMed
Metadata
Title
Carbon Dye Staining of Sentinel Lymph Nodes Facilitates Microstaging of Colon Cancer Patients
Authors
Carsten T. Viehl, MD
Ulrich Guller, MD, MHS
Christian T. Hamel, MD
Hans-Martin Riehle, MD
Christian Plaass, MD
Walter R. Marti, MD
Daniel Oertli, MD
Markus Zuber, MD
Publication date
01-03-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 3/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0336-y

Other articles of this Issue 3/2006

World Journal of Surgery 3/2006 Go to the issue