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Minimal residual disease assessment in sentinel nodes of breast and gastrointestinal cancer: A plea for standardization

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Abstract

Lymph node dissection plays an important role in staging and treatment of solid cancers. Sentinel node biopsy (SNB) has been introduced to minimize the extent of surgery and to enable assessment of minimal residual disease (MRD) without compromising accurate staging or survival. This review addresses the variation in technical aspects and outcome of SNB and MRD assessment in patients with breast and gastrointestinal cancer. Quality control leading to standardization of SNB and pathological examination will enable reliable comparison of studies, which is necessary for consensus of diagnostic and therapeutic strategies.

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References

  1. Tepper JE, O'Connell MJ, Niedzwiecki D, et al. Impact of number of nodes retrieved on outcome in patients with rectal cancer.J Clin Oncol 2001;19:157–63.

    PubMed  CAS  Google Scholar 

  2. Camp RL, Rimm EB, Rimm DL. A high number of tumor free axillary lymph nodes from patients with lymph node negative breast carcinoma is associated with poor outcome.Cancer 2000; 88:108–13.

    Article  PubMed  CAS  Google Scholar 

  3. Le Voyer TE, Sigurdson ER, Hanlon AL, et al. Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089.J Clin Oncol 2003;21:2912–9.

    Article  PubMed  Google Scholar 

  4. Herr HW, Bochner BH, Dalbagni G, et al. Impact of the number of lymph nodes retrieved on outcome in patients with muscle invasive bladder cancer.J Urol 2002;167:1295–8.

    Article  PubMed  Google Scholar 

  5. Overgaard M, Hansen PS, Overgaard J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial.N Engl J Med 1997;337:949–55.

    Article  PubMed  CAS  Google Scholar 

  6. Wong SL, Edwards MJ, Chao C, et al. Sentinel lymph node biopsy for breast cancer: impact of the number of sentinel nodes removed on the false-negative rate.J Am Coll Surg 2001;192:684–9.

    Article  PubMed  CAS  Google Scholar 

  7. Dowlatshahi K, Fan M, Snider HC, et al. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer 1997;80:1188–97.

    Article  PubMed  CAS  Google Scholar 

  8. Noguchi M. Therapeutic relevance of breast cancer micrometastases in sentinel lymph nodes.Br J Surg 2002;89:1505–15.

    Article  PubMed  CAS  Google Scholar 

  9. Dowlatshahi K, Fan M, Bloom KJ, et al. Occult metastases in the sentinel lymph nodes of patients with early stage breast carcinoma: a preliminary study.Cancer 1999;86:990–6.

    Article  PubMed  CAS  Google Scholar 

  10. Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg 1994; 220:391–8.

    Article  PubMed  CAS  Google Scholar 

  11. Cody HS III. Sentinel lymph node mapping in breast cancer.Oncology (Huntingt) 1999;13:25–34.

    Google Scholar 

  12. Schwartz GF, Giuliano AE, Veronesi U. Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 19–22, 2001, Philadelphia, Pennsylvania.Cancer 2002;94:2542–51.

    Article  PubMed  Google Scholar 

  13. Sasako M, McCulloch P, Kinoshita T, et al. New method to evaluate the therapeutic value of lymph node dissection for gastric cancer.Br J Surg 1995;82:346–51.

    PubMed  CAS  Google Scholar 

  14. CJH van de Velde, KCMJ Peeters. The gastric cancer treatment controversy.J Clin Oncol 2003;21:2234–6.

    Article  PubMed  Google Scholar 

  15. Bonenkamp JJ, Songun I, Hermans J, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients.Lancet 1995;345:745–8.

    Article  PubMed  CAS  Google Scholar 

  16. Cuschieri A, Fayers P, Fielding J, et al. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. The Surgical Cooperative Group.Lancet 1996;347:995–9.

    Article  PubMed  CAS  Google Scholar 

  17. Aikou T, Higashi H, Natsugoe S, et al. Can sentinel node navigation surgery reduce the extent of lymph node dissection in gastric cancer?Ann Surg Oncol 2001;8:90S-3S.

    PubMed  CAS  Google Scholar 

  18. Noguchi S, Hiratsuka M, Furukawa H, et al. Detection of gastric cancer micrometastases in lymph nodes by amplification of keratin 19 mRNA with reverse transcriptase-polymerase chain reaction.Jpn J Cancer Res 1996;87:650–4.

    PubMed  CAS  Google Scholar 

  19. Liefers GJ, Cleton-Jansen, AM, van de Velde CJ, et al. Micrometastases and survival in stage II colorectal cancer [see comments].N Engl J Med 1998;339:223–8.

    Article  PubMed  CAS  Google Scholar 

  20. Mori M, Mimori K, Ueo H, et al. Clinical significance of molecular detection of carcinoma cells in lymph nodes and peripheral blood by reverse transcription-polymerase chain reaction in patients with gastrointestinal or breast carcinomas.J Clin Oncol 1998;16:128–32.

    PubMed  CAS  Google Scholar 

  21. Rosenberg R, Hoos A, Mueller J, et al. Prognostic significance of cytokeratin-20 reverse transcriptase polymerase chain reaction in lymph nodes of node-negative colorectal cancer patients.J Clin Oncol 2002;20:1049–55.

    Article  PubMed  Google Scholar 

  22. Noura S, Yamamoto H, Ohnishi T, et al. Comparative detection of lymph node micrometastases of stage II colorectal cancer by reverse transcriptase polymerase chain reaction and immunohistochemistry.J Clin Oncol 2002;20:4232–41.

    Article  PubMed  CAS  Google Scholar 

  23. Tsavellas G, Patel H, Allen-Mersh TG. Detection and clinical significance of occult tumor cells in colorectal cancer.Br J Surg 2001;88:1307–20.

    Article  PubMed  CAS  Google Scholar 

  24. Cutait R, Alves VA, Lopes LC, et al. Restaging of colorectal cancer based on the identification of lymph node micrometastases through immunoperoxidase staining of CEA and cytokeratins.Dis Colon Rectum 1991;34:917–20.

    Article  PubMed  CAS  Google Scholar 

  25. Jeffers MD, O'Dowd GM, Mulcahy H, et al. The prognostic significance of immunohistochemically detected lymph node micrometastases in colorectal carcinoma.J Pathol 1994;172:183–7.

    Article  PubMed  CAS  Google Scholar 

  26. 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;73:563–9.

    Article  PubMed  CAS  Google Scholar 

  27. Adell G, Boeryd B, Franlund B, et al. Occurrence and prognostic importance of micrometastases in regional lymph nodes in Dukes' B colorectal carcinoma: an immunohistochemical study.Eur J Surg 1996;162:637–42.

    PubMed  CAS  Google Scholar 

  28. Broll R, Schauer V, Schimmelpenning H, et al. Prognostic relevance of occult tumor cells in lymph nodes of colorectal carcinomas: an immunohistochemical study.Dis Colon Rectum 1997;40:1465–71.

    Article  PubMed  CAS  Google Scholar 

  29. Sasaki M, Watanabe H, Jass JR, et al. Occult lymph node metastases detected by cytokeratin immunohistochemistry predict recurrence in “node-negative” colorectal cancer.J Gastroenterol 1997; 32:758–64.

    Article  PubMed  CAS  Google Scholar 

  30. Oberg A, Stenling R, Tavelin B, et al. Are lymph node microme-tastases of any clinical significance in Dukes Stages A and B colorectal cancer?Dis Colon Rectum 1998;41:1244–9.

    Article  PubMed  CAS  Google Scholar 

  31. Yasuda K, Adachi Y, Shiraishi N, et al. Pattern of lymph node micrometastasis and prognosis of patients with colorectal cancer.Ann Surg Oncol 2001;8:300–4.

    Article  PubMed  CAS  Google Scholar 

  32. Choi HJ, Choi YY, Hong SH. Incidence and prognostic implications of isolated tumor cells in lymph nodes from patients with Dukes B colorectal carcinoma.Dis Colon Rectum 2002;45:750–5.

    Article  PubMed  Google Scholar 

  33. Wood TF, Tsioulias GJ, Morton DL, et al. Focused examination of sentinel lymph nodes upstages early colorectal carcinoma.Am Surg 2000;66:998–1003.

    PubMed  CAS  Google Scholar 

  34. Tsioulias GJ, Wood TF, Morton DL, et al. Lymphatic mapping and focused analysis of sentinel lymph nodes upstage gastrointestinal neoplasms.Arch Surg 2000;135:926–32.

    Article  PubMed  CAS  Google Scholar 

  35. Kitagawa Y, Watanabe M, Hasegawa H, et al. Sentinel node mapping for colorectal cancer with radioactive tracer.Dis Colon Rectum 2002;45:1476–1480.

    Article  PubMed  Google Scholar 

  36. Nwariaku FE, Euhus DM, Beitsch PD, et al. Sentinel lymph node biopsy, an alternative to elective axillary dissection for breast cancer.Am J Surg 1998;176:529–31.

    Article  PubMed  CAS  Google Scholar 

  37. Borgstein PJ, Pijpers R, Comans EF, et al. Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection.J Am Coll Surg 1998;186:275–83.

    Article  PubMed  CAS  Google Scholar 

  38. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer—a multicenter validation study.N Engl J Med 1998;339:941–6.

    Article  PubMed  CAS  Google Scholar 

  39. Hill AD, Mann GB, Borgen PI, et al. Sentinel lymphatic mapping in breast cancer.J Am Coll Surg 1999;188:545–9.

    Article  PubMed  CAS  Google Scholar 

  40. Veronesi U, Paganelli G, Viale G, et al. Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series.J Natl Cancer Inst 1999;91:368–73.

    Article  PubMed  CAS  Google Scholar 

  41. Winchester DJ, Sener SF, Winchester DP, et al. Sentinel lymphadenectomy for breast cancer: experience with 180 consecutive patients: efficacy of filtered technetium 99m sulphur colloid with overnight migration time.J Am Coll Surg 1999;188:597–603.

    Article  PubMed  CAS  Google Scholar 

  42. Bass SS, Cox CE, Ku NN, et al. The role of sentinel lymph node biopsy in breast cancer.J Am Coll Surg 1999;189:183–94.

    Article  PubMed  CAS  Google Scholar 

  43. Morrow M, Rademaker AW, Bethke KP, et al. Learning sentinel node biopsy: results of a prospective randomized trial of two techniques.Surgery 1999;126:714–20.

    PubMed  CAS  Google Scholar 

  44. Fraile M, Rull M, Julian FJ, et al. Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: an approach to its validity.Ann Oncol 2000;11:701–5.

    Article  PubMed  CAS  Google Scholar 

  45. Kollias J, Gill PG, Chatterton BE, et al. Reliability of sentinel node status in predicting axillary lymph node involvement in breast cancer.Med J Aust 1999;171:461–5.

    PubMed  CAS  Google Scholar 

  46. Tafra L. The learning curve and sentinel node biopsy.Am J Surg 2001;182:347–50.

    Article  PubMed  CAS  Google Scholar 

  47. Nano MT, Kollias J, Farshid G, et al. Clinical impact of falsenegative sentinel node biopsy in primary breast cancer.Br J Surg 2002;89:1430–4.

    Article  PubMed  CAS  Google Scholar 

  48. Hiratsuka M, Miyashiro I, Ishikawa O, et al. Application of sentinel node biopsy to gastric cancer surgery.Surgery 2001;129:335–40.

    Article  PubMed  CAS  Google Scholar 

  49. Yasuda S, Shimada H, Ogoshi K, et al. Preliminary study for sentinel lymph node identification with Tc-99m tin colloid in patients with esophageal or gastric cancer.Tokai J Exp Clin Med 2001;26:15–8.

    PubMed  CAS  Google Scholar 

  50. Ichikura T, Morita D, Uchida T, et al. Sentinel node concept in gastric carcinoma.World J Surg 2002;26:318–22.

    Article  PubMed  Google Scholar 

  51. Kitagawa Y, Fujii H, Mukai M, et al. Radio-guided sentinel node detection for gastric cancer.Br J Surg 2002;89:604–8.

    Article  PubMed  CAS  Google Scholar 

  52. Miwa K, Kinami S, Taniguchi K, et al. Mapping sentinel nodes in patients with early-stage gastric carcinoma.Br J Surg 2003;90:178–82.

    Article  PubMed  CAS  Google Scholar 

  53. Maehara Y, Oshiro T, Endo K, et al. Clinical significance of occult micrometastasis lymph nodes from patients with early gastric cancer who died of recurrence.Surgery 1996;119:397–402.

    Article  PubMed  CAS  Google Scholar 

  54. Cai J, Ikeguchi M, Maeta M, et al. Micrometastasis in lymph nodes and microinvasion of the muscularis propria in primary lesions of submucosal gastric cancer.Surgery 2000;127:32–9.

    Article  PubMed  CAS  Google Scholar 

  55. Morgagni P, Saragoni L, Folli S, et al. Lymph node micrometastases in patients with early gastric cancer: experience with 139 patients.Ann Surg Oncol 2001;8:170–4.

    Article  PubMed  CAS  Google Scholar 

  56. Fukagawa T, Sasako M, Mann GB, et al. Immunohistochemically detected micrometastases of the lymph nodes in patients with gastric carcionma.Cancer 2001;92:753–60.

    Article  PubMed  CAS  Google Scholar 

  57. Lee E, Chae Y, Kim I, et al. Prognostic relevance of immunohistochemically detected lymph node micrometastasis in patients with gastric carcinoma.Cancer 2002;94:2867–73.

    Article  PubMed  Google Scholar 

  58. Joosten JJ, Strobbe LJ, Wauters CA, et al. Intraoperative lymphatic mapping and the sentinel node concept in colorectal carcinoma.Br J Surg 1999;86:482–6.

    Article  PubMed  CAS  Google Scholar 

  59. Wiese DA, Saha S, Badin J, et al. Pathologic evaluation of sentinel lymph nodes in colorectal carcinoma.Arch Pathol Lab Med 2000; 124:1759–63.

    PubMed  CAS  Google Scholar 

  60. Feig BW, Curley S, Lucci A, et al. A caution regarding lymphatic mapping in patients with colon cancer.Am J Surg 2001;182:707–12.

    Article  PubMed  CAS  Google Scholar 

  61. Wong JH, Steineman S, Calderia C, et al. Ex vivo sentinel node mapping in carcinoma of the colon and rectum.Ann Surg 2001; 233:515–21.

    Article  PubMed  CAS  Google Scholar 

  62. 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-8S.

    PubMed  CAS  Google Scholar 

  63. Merrie AE, van Rij AM, Phillips LV, et al. Diagnostic use of the sentinel node in colon cancer.Dis Colon Rectum 2001;44:410–7.

    Article  PubMed  CAS  Google Scholar 

  64. Esser S, Reilly WT, Riley LB, et al. The role of sentinel lymph node mapping in staging of colon and rectal cancer.Dis Colon Rectum 2001;44:850–4.

    Article  PubMed  CAS  Google Scholar 

  65. Broderick-Villa G, Ko A, O'Connell TX, et al. Does tumor burden limit the accuracy of lymphatic mapping and sentinel lymph node biopsy in colorectal cancer?Cancer J 2002;8:445–50.

    Article  PubMed  Google Scholar 

  66. Wood TF, Nora DT, Morton DL, et al. One hundred consecutive cases of sentinel lymph node mapping in early colorectal carcinoma: detection of missed micrometastases.J Gastrointest Surg 2002;6:322–9.

    Article  PubMed  Google Scholar 

  67. Bilchik AJ, Nora D, Tollenaar RA, et al. Ultrastaging of early colon cancer using lymphatic mapping and molecular analysis.Eur J Cancer 2002;38:977–85.

    Article  PubMed  CAS  Google Scholar 

  68. Fitzgerald TL, Khalifa MA, Al Zahrani M, et al. Ex vivo sentinel lymph node biopsy in colorectal cancer: a feasibility study.J Surg Oncol 2002;80:27–32.

    Article  PubMed  CAS  Google Scholar 

  69. Paramo JC, Summerall J, Poppiti R, et al. Validation of sentinel node mapping in patients with colon cancer.Ann Surg Oncol 2002;9:550–4.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery K6-R, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands

    Fania S. Doekhie MD, Koen C. M. J. Peeters MD, Rob A. E. M. Tollenaar MD, PhD & Cornelis J. H. van de Velde MD, PhD

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  1. Fania S. Doekhie MD
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  2. Koen C. M. J. Peeters MD
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  3. Rob A. E. M. Tollenaar MD, PhD
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  4. Cornelis J. H. van de Velde MD, PhD
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Correspondence to Cornelis J. H. van de Velde MD, PhD.

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Doekhie, F.S., Peeters, K.C.M.J., Tollenaar, R.A.E.M. et al. Minimal residual disease assessment in sentinel nodes of breast and gastrointestinal cancer: A plea for standardization. Annals of Surgical Oncology 11 (Suppl 3), 236S–241S (2004). https://doi.org/10.1007/BF02523636

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