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Predictive value of the sentinel lymph node procedure in the staging of non-metastatic colorectal cancer

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Abstract

Purpose

Despite the recent growing interest of the scientific community, there is still no consensus on the actual applicability and effectiveness of sentinel lymph node (SL) procedure in colon cancers. This study aims to quantify feasibility, detection rate, negative predictive value, and accuracy of the SL identified with fluorescent dye in early colon cancers (ECC).

Methods

This study conducted a consecutive sampling of 95 patients with non-metastatic colorectal cancer who have been treated with laparoscopic colon resection and complete mesocolic excision after a 25-mg indocyanine green peritumoral laparoscopic injection and SL identification with a near-infrared camera. The SL was later isolated and sent to ultra-staging.

Results

Ninety-five patients with an average age of 71 (range 37–90) and a mean BMI of 25 (range 18–39) have been recruited. On the patient sample (92 Pts), an average of 1.49 SL (range 1–5) and a mean time of 4 min were identified. The detection rate was 96.8% and the negative predictive value and accuracy rates were 96.2% and 93.4%, respectively.

Conclusions

Mapping the SL with fluorescent dye can play an important role in the treatment of colon cancers, particularly those at early stages, and can lead to ultra-conservative surgery.

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Acknowledgments

We would like to thank all patients who participated in this study.

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Authors and Affiliations

  1. Department of General Surgery, S. Chiara Hospital, Trento, Italy

    A. Carrara, M. Motter, D. Amabile, L. Pellecchia, P. Moscatelli & G. Tirone

  2. Department of Clinical and Evaluative Epidemiology, Health Service of Trento, Trento, Italy

    R. Pertile

  3. Department of Anatomical Pathology, S. Chiara Hospital, Trento, Italy

    M. Barbareschi & N. L. Decarli

  4. Department of Radiology, S. Chiara Hospital, Trento, Italy

    M. Ferrari

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Contributions

All authors contributed equally to this work, satisfying the following four criteria of the guidelines of the International Committee of Medical Journal Editors (ICMJE): substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to A. Carrara.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

The study protocol has been approved by the Ethical Committee of the Provincial Health Service of the Province of Trento (Record n. 5/2012 ID 31615721).

This article does not contain any studies using animals.

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Informed consent was obtained from the participant included in the study.

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Carrara, A., Motter, M., Amabile, D. et al. Predictive value of the sentinel lymph node procedure in the staging of non-metastatic colorectal cancer. Int J Colorectal Dis 35, 1921–1928 (2020). https://doi.org/10.1007/s00384-020-03654-3

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  • DOI: https://doi.org/10.1007/s00384-020-03654-3

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