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Sentinel Lymph Node Mapping in Colon Cancer: Current Status

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ABSTRACT

Background

The primary role of sentinel lymph node (SLN) mapping in colon cancer is to increase the accuracy of nodal staging by identifying those lymph nodes with the greatest potential for harbouring metastatic disease. Ultrastaging techniques aim to identify the otherwise undetected metastases. Until now, no consensus exists as to the most optimal procedure in patients with colon cancer.

Methods

A systematic literature search on the value of different SLN mapping techniques in patients with colon cancer was performed using the electronic search engine PubMed. Prospective studies published before 1 December 2005 were included and further articles were selected by cross-referencing. The results of different techniques using either blue dye or radiocolloid, were investigated.

Results

The literature search yielded 17 relevant articles. SLN mapping using blue dye was described in 15 studies. Two studies reported the results of SLN mapping using a combination of blue dye and radiocolloid. The reported results on identification rate varied between 71 and 100%. Accuracy rates were between 78 and 100%, sensitivity rates between 25 and 100% and true upstaging rates between 0 and 26%. The results were not affected by the addition of radiocolloid to blue dye.

Conclusions

Sentinel lymph node mapping in patients with colon cancer remains an experimental procedure with varying results. Further evaluation may lead to a standardized technique that offers the potential for significant upstaging of stage II patients. This may have important implications as to tailor adjuvant chemotherapeutic regimens in these patients.

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Acknowledgments

We thank Dr. A. N. Kimmings, surgeon, for her help in the preparation of the manuscript.

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Authors and Affiliations

  1. Department of Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands

    Robbert J. de Haas, Dennis A. Wicherts, Inne H. M. Borel Rinkes MD, PhD, Joke-Afke van der Zee MD & Richard van Hillegersberg MD, PhD

  2. Department of Nuclear Medicine, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands

    Monique G. G. Hobbelink MD

  3. Department of Pathology, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands

    Marguerite E. I. Schipper MD

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  1. Robbert J. de Haas
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  2. Dennis A. Wicherts
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Corresponding author

Correspondence to Richard van Hillegersberg MD, PhD.

Additional information

Robbert J. de Haas and Dennis A. Wicherts have contributed equally and are mentioned alphabetically.

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de Haas, R.J., Wicherts, D.A., Hobbelink, M.G.G. et al. Sentinel Lymph Node Mapping in Colon Cancer: Current Status. Ann Surg Oncol 14, 1070–1080 (2007). https://doi.org/10.1245/s10434-006-9258-7

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