Abstract
Sentinel node (SN) identification in patients with lung cancer is useful not only to minimize lymph node dissection, but also to target the best lymph nodes for intraoperative frozen section during segmentectomy. Since 2000, we have identified the SN in lung cancer patients using radioisotope (RI). This review presents our data on SN identification, describing the following: the procedure, using a radioisotope tracer; the flow of Tc-99 tin colloid after the injection; the characteristics of patients whose SNs could not be identified; ex vivo SN identification; reliability of in vivo SN identification; the algorithm for reducing mediastinal lymph node dissection; the differences in SN identification between large and small radioisotope particles; SNs at segmental lymph nodes; SN navigation segmentectomy for clinical stage IA non-small cell lung cancer; and small metastasis in the SN.
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Little AG, DeHoyos A, Kirgan DM, Arcomno TR, Murray KD. Intraoperative lymphatic mapping for non-small cell lung cancer: the sentinel node technique. J Thorac Cardiovasc Surg 1999;117:220–224.
Liptay MJ, Masters GA, Winchester DJ, Edelman BL, Carrido BJ, Hirshctritt TR, et al. Intraoperative radioisotope sentinel lymph node mapping in non-small cell lung cancer. Ann Thorac Surg 2000;70:384–390.
Nomori H, Horio H, Naruke T, Orikasa H, Yamazaki K, Suemasu K. Use of technetium-99m tin colloid for sentinel lymph node identification in non-small cell lung cancer. J Thorac Cardiovasc Surg 2001;124:486–492.
Nomori H, Watanabe K, Ohtsuka T, Naruke T, Suemasu K. In vivo identification of sentinel lymph nodes for clinical stage I nonsmall cell lung cancer for abbreviation of mediastinal lymph node dissection. Lung Cancer 2004;46:49–55.
Nomori H, Ikeda K, Mori T, Shiraishi S, Kobayashi H, Iwatani K, et al. Sentinel node identification in clinical stage Ia non-small cell lung cancer by a combined single photon emission computed tomography/computed tomography system. J Thorac Cardiovasc Surg 2007;134:182–187.
Nomori H, Ohba Y, Yoshimoto K, Shibata H, Mori T, Shiraishi S, et al. Difference of sentinel lymph node identification between tin colloid and phytate in patients with non-small cell lung cancer. Ann Thorac Surg 2009;87:906–910.
Ikeda K, Nomori H, Mori T, Kobayashi H, Iwatani K, Yoshimoto K. Size of metastatic and non-metastatic mediastinal lymph nodes in non-small cell lung cancer. J Thorac Oncol 2006;1:949–952.
Nomori H, Ikeda K, Mori T, Kobayashi H, Iwatani K, Kawanaka K, et al. Sentinel node navigation segmentectomy for c-T1N0M0 non-small cell lung cancer. J Thorac Cardiovasc Surg 2007;133:780–785.
Nomori H, Ohba Y, Shibata H, Shiraishi K, Mori T, Shiraishi S. Required area of lymph node sampling during segmentectomy for clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg 2010;139:38–42.
Nomori H. Sentinel node mapping in lung cancer. The Japanese experience. Semin Thorac Cardiovasc Surg 2009;21:316–322.
Goldstraw P (editor). Staging manual in thoracic oncology. International Association for the Study of Lung Cancer; 2009. p. 74–75.
Riquet M, Hidden G, Debesse B. Direct lymphatic drainage of lung segments to the mediastinal nodes. J Thorac Cardiovasc Surg 1989;97:623–632.
Naruke T, Tsuchiya R, Kondo H, Nakayama H, Asamura H. Lymph node sampling in lung cancer: how should it be done? Eur J Cardiothorac Surg 1999;16:S17–S24.
Asamura H, Nakayama H, Kondo H, Tsuchiya R, Naruke T. Lobespecific extent of systemic lymph node dissection for non-small cell lung carcinomas according to a retrospective study of metastases and prognosis. J Thorac Cardiovasc Surg 1999;117:1102–1111.
Okada M, Tsubota N, Yoshimura M, Miyamoto Y, Matsuoka H. Prognosis of completely resected pN2 non-small cell lung carcinomas: what is the significant node that affects survival? J Thorac Cardiovasc Surg 1999;118:270–275.
Shimazu K, Tamaki Y, Taguchi T, Takamura Y, Nobuchi S. Comparison between periaeolar and peritumoral injection of radiotracer for sentinel lymph node biopsy in patients with breast cancer. Surgery 2002;131:277–286.
Campbell J, Bellen JC, Baker RJ, Cook DJ. Technetium-99m calcium phytate — optimization of calcium content for liver and spleen scintigraphy: concise communication. J Nucl Med 1981;22:157–160.
McMasters KM, Reintgen DS, Ross MI, Wong SL, Gershenwald JE, Krag DN, et al. Sentinel lymph node biopsy for melanoma: how many radioactive nodes should be removed? Ann Surg Oncol 2001;8:192–197.
Yamanaka A, Hirai T, Fujimoto T, Ohtake Y, Konishi F. Analyses of segmental lymph node metastases and intrapulmonary metastases of small lung cancer. Ann Thorac Surg 2000;70:1624–1628.
Izbicki JR, Passlick B, Hosch SB, Kubuschock B, Schneider C, Busch C, et al. Mode of spread in the early phase of lymphatic metastasis in non-small cell lung cancer: significance of nodal micrometastasis. J Thorac Cardiovasc Surg 1996;112:623–630.
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Nomori, H., Kohno, M., Izumi, Y. et al. Sentinel nodes in lung cancer: Review of our 10-year experience. Surg Today 41, 889–895 (2011). https://doi.org/10.1007/s00595-010-4528-1
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DOI: https://doi.org/10.1007/s00595-010-4528-1