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Sentinel Node Biopsy in Squamous-Cell Carcinoma of the Anal Canal

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Radiochemotherapy is the standard treatment for patients with carcinoma of the anal canal. Therefore, a surgical specimen is not usually obtained. Inguinal lymph node metastases cannot be accurately predicted by either clinical examination or imaging techniques. In this study, we applied the sentinel node technique in patients with anal canal squamous-cell carcinoma to determine whether this provided more reliable staging of tumors.

Methods

From May 2007 to May 2009, we enrolled 11 patients (7 women) with a mean age 65 (range 39–80) years with squamous-cell carcinoma of the anal canal and clinically and radiologically negative groin lymph nodes. The patients were staged with endorectal ultrasound, computed tomographic scan, magnetic resonance imaging of the pelvis, and positron emission tomography. There were two T1, four T2, and five T3 tumors (International Union Against Cancer classification). Lymphoscintigraphy with peritumoral 99mTc colloid injection was performed 16 to 18 h before surgery. During the surgery, patent blue dye was injected peritumorally, and the sentinel inguinal node was identified by a handheld gamma probe and dye visualization.

Results

The sentinel lymph node was detected in all 11 patients by scintigraphy; in 9 cases, the lymph node was in the inguinal region. All of these patients underwent radioguided node biopsy, and a total of 12 lymph nodes were removed. The average diameter of the resected nodes was 8 (range 4–20) mm. No serious complications occurred. In three patients, metastases were identified in the lymph node.

Conclusions

Sentinel node biopsy is a more accurate method than clinical or radiological techniques to stage the disease of patients with anal carcinoma.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Scientific Institute San Raffaele Hospital, Milan, Italy

    Paola De Nardi MD, Michele Carvello MD & Carlo Staudacher MD

  2. Department of Nuclear Medicine, Scientific Institute San Raffaele Hospital, Milan, Italy

    Carla Canevari MD

  3. Department of Radiotherapy, Scientific Institute San Raffaele Hospital, Milan, Italy

    Paolo Passoni MD

Authors
  1. Paola De Nardi MD
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  2. Michele Carvello MD
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  3. Carla Canevari MD
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  4. Paolo Passoni MD
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  5. Carlo Staudacher MD
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Corresponding author

Correspondence to Paola De Nardi MD.

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De Nardi, P., Carvello, M., Canevari, C. et al. Sentinel Node Biopsy in Squamous-Cell Carcinoma of the Anal Canal. Ann Surg Oncol 18, 365–370 (2011). https://doi.org/10.1245/s10434-010-1275-x

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  • DOI: https://doi.org/10.1245/s10434-010-1275-x

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