Annals of Surgical Oncology

, Volume 11, Supplement 3, pp 245S–249S | Cite as

Historical review of lymphatic mapping in gastrointestinal malignancies

  • Sukamal Saha
  • Adrian G. Dan
  • Anton J. Bilchik
  • Yuko Kitagawa
  • Elie Schochet
  • Sharan Choudhri
  • Lucille T. Saha
  • David Wiese
  • Donald Morton
  • Masaki Kitajima


The advent of sentinel lymph node mapping (SLNM) has had a profound impact on the surgical management of breast cancer and melanoma over the past decade. However, SLNM in gastrointestinal malignancies is still in its infancy. The role of SLNM in gastrointestinal malignancies is to increase staging accuracy and to reduce the understaging associated with standard surgical and pathological techniques. Numerous authors have described the successful use of SLNM in colon, rectal, gastric, esophageal, and anal canal malignancies, with a high degree of accuracy and upstaging by detailed pathological analysis of the sentinel nodes. Over the past 2 years, research and publications related to gastrointestinal lymphatic mapping have dramatically increased worldwide.

Key Words

Gastrointestinal malignancies History Sentinel node Lymph mapping 


  1. 1.
    Osborne MP, Rosenbaum-Smith SM. The historic background of lymphatic mapping. In: Cody HS III, ed.Sentinel Lymph Node Biopsy. London: Martin Dunitz Ltd, 2002:3–10.Google Scholar
  2. 2.
    Weinberg J, Greaney EM, Identification of regional lymph nodes by means of a vital staining dye during surgery of gastric cancer.Surg Gynecol Obstet 1950;90:561–7.PubMedGoogle Scholar
  3. 3.
    Morl F.Chirurg 1952;23:238.Google Scholar
  4. 4.
    Sherman AI, Ter-Pogossian M. Lymph node concentration of radioactive colloidal gold following interstitial injection.Cancer 1953;6:1238–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Gould EA, Winship T, Philbin PH, et al. Observations on a “sentinel node” in cancer of the parotid.Cancer 1960;13:77–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Kett K, Varga G, Lukacs L. Direct lymphography of the breast.Lymphology 1970;3:2–12.PubMedGoogle Scholar
  7. 7.
    Cabanas RM. An approach for the treatment of penile carcinoma.Cancer 1977;39:456–66.PubMedCrossRefGoogle Scholar
  8. 8.
    Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma.Arch Surg 1992;127:392–9.PubMedGoogle Scholar
  9. 9.
    Robinson DS, Sample WF, Fee HJ, Holmes C, Morton DL. Regional lymphatic drainage in primary malignant melanoma of the trunk determined by colloidal gold scanning.Surg Forum 1977; 28:147–8.PubMedGoogle Scholar
  10. 10.
    Fee HJ, Robinson DS, Sample WF, Graham LS, Holmes EC, Morton DL. The determination of lymph shed by colloidal gold scanning in patients with malignant melanoma: a preliminary study.Surgery 1978;84:626–32.PubMedGoogle Scholar
  11. 11.
    Holmes EC, Moseley HS, Morton DL, Clark W, Robinson D, Urist MM. A rational approach to the surgical management of melanoma.Ann Surg 1977;186:481–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Krag DN, Weaver DL, Alex JC, et al. Surgical resection and radiolocalization of the sentinel node in breast cancer using a gamma probe.Surg Oncol 1993;2:335–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg 1994; 220:391–401.PubMedCrossRefGoogle Scholar
  14. 14.
    Saha S, Ganatra BK, Gauthier J, et al. Localization of sentinel lymph node in colon cancer. A feasibility study.SSO 50th Annual Cancer Symposium 1997;80:54.Google Scholar
  15. 15.
    Messina JL, Reintgen DS, Cruse CW, et al. Selective lymphadenectomy in patients with Merkel cell (cutaneous neuroendocrine) carcinoma.Ann Surg Oncol 1997;4:389–95.PubMedCrossRefGoogle Scholar
  16. 16.
    Keleman PR, van Herle AJ, Giuliano AE. Sentinel lymphadenectomy in thyroid malignant neoplasms.Arch Surg 1998;133:288–92.CrossRefGoogle Scholar
  17. 17.
    de Hullu JA, Doting ME, Piers DA, et al. Sentinel lymph node identification with technetium-99m-labeled nanocolloid in squamous cell cancer of the vulva.J Nucl Med 1998;39:1381–5.PubMedGoogle Scholar
  18. 18.
    Wawroschek F, Vogt H, Weckermann D, et al. The sentinel lymph node concept in prostate cancer-first results of gamma probeguided sentinel lymph node identification.Eur Urol 1999;36:595–600.PubMedCrossRefGoogle Scholar
  19. 19.
    Little AG, Dehoyos A, Kirgan DM, et al. Intraoperative lymphatic mapping for non-small cell lung cancer: the sentinel node technique.J Thorac Cardiovasc Surg 1999;117:220–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Kitagawa Y, Fugii H, Mukai M, et al. The role of the sentinel lymph node in gastrointestinal cancer.Surg Clin North Am 2000; 80:1799–809.PubMedCrossRefGoogle Scholar
  21. 21.
    Keshtgar MR, Amin A, Taylor I, et al. The sentinel node in anal carcinoma.Eur J Oncol 2001;27:113–4.CrossRefGoogle Scholar
  22. 22.
    Haboubi NY, Clark P, Kaftan SM, et al. The importance of combining xylene clearance and immunohistochemistry in the accurate staging of colorectal carcinoma.J Royal Soc Med 1992;85:386–8.Google Scholar
  23. 23.
    Rodriguez-Bigas MA, Maamoun S, Weber TK, et al. Clinical significance of colorectal cancer: metastases in lymph nodes <5mm in size.Ann Surg Oncol 1996;3:124–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Swanson RS, Compton CC, Stewart AK, et al. The Prognosis of T3N0 colon cancer is dependent on the number of lymph nodes examined.Ann Surg Oncol 2003;10:65–71.PubMedCrossRefGoogle Scholar
  25. 25.
    Goldstein NS, Sanford W, Coffey M, et al. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends overtime and a recommendation for a minimum number of lymph nodes to be recovered.Am J Clin Pathol 1996;106:209–16.PubMedGoogle Scholar
  26. 26.
    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.PubMedGoogle Scholar
  27. 27.
    Saha S, Espinosa M, Wiese D, et al. Accurate staging of colorectal cancer by sentinel lymph node mapping. A prospective study.Proceedings of the 17th International Cancer Congress 1998;2: 1005–11.Google Scholar
  28. 28.
    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.PubMedCrossRefGoogle Scholar
  29. 29.
    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;7:120–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Tsioulias G, Wood T, Morton D, et al. Lymphatic mapping and focused analysis of sentinel lymph nodes upstage gastrointestinal neoplasms.Arch Surg 2000;135:926–32.PubMedCrossRefGoogle Scholar
  31. 31.
    Saha S, Nora D, Wong JH, et al. Sentinel lymph node mapping in colorectal cancer-a review.Surg Clin Of N Am 2000;80:1811–9.CrossRefGoogle Scholar
  32. 32.
    Thorn M. Lymphatic mapping and sentinel node biopsy: is the method applicable to patients with colorectal and gastric cancer?Eur J Surg 2000;166:755–8.PubMedCrossRefGoogle Scholar
  33. 33.
    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.PubMedCrossRefGoogle Scholar
  34. 34.
    Wood TF, Saha S, Morton DL, et al. Validation of lymphatic mapping in colorectal cancer: in vivo, ex vivo, and laparoscopic techniques.Ann Surg Oncol 2001;8:150–7.PubMedCrossRefGoogle Scholar
  35. 35.
    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.PubMedCrossRefGoogle Scholar
  36. 36.
    Kitagawa Y, Ohgami M, Fujii H, et al. Laparoscopic detection of sentinel lymph nodes in gastrointestinal cancer: a novel and minimally invasive approach.Ann Surg Oncol 2001;8:86–9S.Google Scholar
  37. 37.
    Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial.J Clin Oncol 2001;19:1128–36.PubMedGoogle Scholar
  38. 38.
    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;8:94–8S.Google Scholar
  39. 39.
    Bendavid Y, Latulippe JF, Younan RJ, et al. Phase I study on sentinel lymph node mapping in colon cancer: a preliminary report.J Surg Oncol 2002;79:81–4.PubMedCrossRefGoogle Scholar
  40. 40.
    Evangelista W, Satolli M, Malossi A, et al. Sentinel lymph node mapping in colorectal cancer: A feasibility study.Tumori 2002; 88:37–40.PubMedGoogle Scholar
  41. 41.
    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.PubMedCrossRefGoogle Scholar
  42. 42.
    Yoshida K, Itabashi M, Kameoka S. Detection of sentinel lymph nodes of colon cancer using a dye method and its practical applications.Proceedings of the 3rd International Sentinel Lymph Node Congress 2002;60:168.Google Scholar
  43. 43.
    Dan A, Saha S, Weise D, et al. Comparative analysis of Lymphazurin 1% vs. Fluorescein 10% in sentinel lymph node (SLN) mapping for colorectal (CR) tumors.Proceedings of the 3rd International Sentinel Lymph Node Congress 2002;5:167.Google Scholar
  44. 44.
    Kane JM III, Kahlenberg MS, Rodriguez-Bigas MA, et al. Intraoperative hepatic lymphatic mapping in patients with liver metastases from colorectal carcinoma.Am Surg 2002;68:745–50.PubMedGoogle Scholar
  45. 45.
    Bilchik AJ, Saha S, Tsioulias GJ, et al. Aberrant drainage and missed micrometastases: the value of lymphatic mapping and focused analysis of sentinel lymph nodes in gastrointestinal neoplasms.Ann Surg Oncol 2001;8:82–5S.Google Scholar
  46. 46.
    Kitagawa Y, Fujii H, Mukai M, et al. Current Status and Future Perspectives of Sentinel Node Navigation for Gastrointestinal Cancer.Proceedings of the 3rd International Sentinel Lymph Node Congress 2002;2:136.Google Scholar
  47. 47.
    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;8:90–3S.Google Scholar
  48. 48.
    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.PubMedCrossRefGoogle Scholar
  49. 49.
    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.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc. 2004

Authors and Affiliations

  • Sukamal Saha
    • 1
  • Adrian G. Dan
    • 1
  • Anton J. Bilchik
    • 2
  • Yuko Kitagawa
    • 3
  • Elie Schochet
    • 1
  • Sharan Choudhri
    • 1
  • Lucille T. Saha
    • 1
  • David Wiese
    • 1
  • Donald Morton
    • 2
  • Masaki Kitajima
    • 3
  1. 1.Department of SurgeryMichigan State University and McLaren Regional Medical Center
  2. 2.Department of SurgeryJohn Wayne Cancer InstituteSanta Monica
  3. 3.Department of SurgeryKeio University School of MedicineTokyoJapan

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