Sentinel Lymph Node Procedure Leads to Upstaging of Patients with Resectable Colon Cancer: Results of the Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer
Background The value of the sentinel lymph node (SLN) procedure in colon cancer patients remains a matter of debate. The objective of this prospective, multicenter trial was 3-fold: to determine the identification rate and accuracy of the SLN procedure in patients with resectable colon cancer; to ev...
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| Veröffentlicht in: | Annals of surgical oncology 2012-06, Vol.19 (6), p.1959-1965 |
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| container_issue | 6 |
| container_start_page | 1959 |
| container_title | Annals of surgical oncology |
| container_volume | 19 |
| creator | Viehl, Carsten T. Guller, Ulrich Cecini, Ramona Langer, Igor Ochsner, Alex Terracciano, Luigi Riehle, Hans-Martin Laffer, Urban Oertli, Daniel Zuber, Markus |
| description | Background
The value of the sentinel lymph node (SLN) procedure in colon cancer patients remains a matter of debate. The objective of this prospective, multicenter trial was 3-fold: to determine the identification rate and accuracy of the SLN procedure in patients with resectable colon cancer; to evaluate the learning curve of the SLN procedure; and to assess the extent of upstaging due to the SLN procedure.
Methods
One hundred seventy-four consecutive colon cancer patients were enrolled onto this prospective trial. They underwent an intraoperative SLN procedure with isosulfan blue 1% injected peritumorally followed by open standard colon resection with oncologic lymphadenectomy. Three levels of each SLN were stained with hematoxylin and eosin (H&E) and immunostained with the pancytokeratin marker AE1/AE3 if H&E was negative.
Results
SLN identification rate and accuracy were 89.1% and 83.9%, respectively. SLN were significantly more likely to contain tumor infiltrates than non-SLN (
P
15% of node-negative patients. The potential advantage of performing the SLN procedure appears to be particularly important in these patients because they may potentially benefit from adjuvant therapy. |
| doi_str_mv | 10.1245/s10434-012-2233-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1015245464</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1015245464</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-77049ed8eaa0415ef9832def7f3ebdedeaf957f96e5312cc6867980de27beda33</originalsourceid><addsrcrecordid>eNp9kUuP0zAUhS0EYh7wA9ggS2xYTMDvJOxQxUsqMKLMOnLtm9ajNA62w6j_jR_HLR0QIMHKls93zr3yIeQRZ8-4UPp55kxJVTEuKiGkrMwdcso1vijT8Lt4Z6apWmH0CTnL-ZoxXkum75MTpIVoNT8l31YwljDCQJf73bSlH6IHepmiAz8noEuwPtMS6dWUi92EcUNjTy9tCWjL9CaULf0EGVyx6wHoIg5xpAs7OkgvDsI8IIWOsgW6ugk5H7LzhHz4Chf0PerBYRQkuiqz39P_rxPGP0Y8IPd6O2R4eHuek6vXrz4v3lbLj2_eLV4uKydrUaq6ZqoF34C1THENfdtI4aGvewlrDx5s3-q6bw1oyYVzpjF12zAPol6Dt1Kek6fH3CnFLzPk0u1CdjAMdoQ4544zrrEPZRSiT_5Cr-OcRtzuB8U4b5VAih8ph7-RE_TdlMLOpj1C3aHa7lhth9V2h2o7g57Ht8nzegf-l-NnlwiII5BRGjeQfh_9r9TviP6xgg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1015011942</pqid></control><display><type>article</type><title>Sentinel Lymph Node Procedure Leads to Upstaging of Patients with Resectable Colon Cancer: Results of the Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer</title><source>MEDLINE</source><source>SpringerLink</source><creator>Viehl, Carsten T. ; Guller, Ulrich ; Cecini, Ramona ; Langer, Igor ; Ochsner, Alex ; Terracciano, Luigi ; Riehle, Hans-Martin ; Laffer, Urban ; Oertli, Daniel ; Zuber, Markus</creator><creatorcontrib>Viehl, Carsten T. ; Guller, Ulrich ; Cecini, Ramona ; Langer, Igor ; Ochsner, Alex ; Terracciano, Luigi ; Riehle, Hans-Martin ; Laffer, Urban ; Oertli, Daniel ; Zuber, Markus</creatorcontrib><description>Background
The value of the sentinel lymph node (SLN) procedure in colon cancer patients remains a matter of debate. The objective of this prospective, multicenter trial was 3-fold: to determine the identification rate and accuracy of the SLN procedure in patients with resectable colon cancer; to evaluate the learning curve of the SLN procedure; and to assess the extent of upstaging due to the SLN procedure.
Methods
One hundred seventy-four consecutive colon cancer patients were enrolled onto this prospective trial. They underwent an intraoperative SLN procedure with isosulfan blue 1% injected peritumorally followed by open standard colon resection with oncologic lymphadenectomy. Three levels of each SLN were stained with hematoxylin and eosin (H&E) and immunostained with the pancytokeratin marker AE1/AE3 if H&E was negative.
Results
SLN identification rate and accuracy were 89.1% and 83.9%, respectively. SLN were significantly more likely to contain tumor infiltrates than non-SLN (
P
< 0.001). Both SLN identification rate (
P
= 0.021) and the sensitivity of the procedure (
P
= 0.043) significantly improved with experience. The use of immunohistochemistry in SLN resulted in an upstaging of 15.4% (16 of 104) stage I and II patients considered node-negative in initial H&E analysis.
Conclusions
The SLN procedure for colon cancer has good identification and accuracy rates, which further improve with increasing experience. Most importantly, the SLN procedure results in upstaging of >15% of node-negative patients. The potential advantage of performing the SLN procedure appears to be particularly important in these patients because they may potentially benefit from adjuvant therapy.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-012-2233-6</identifier><identifier>PMID: 22322951</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Colonic Neoplasms - pathology ; Colonic Neoplasms - surgery ; Colorectal Cancer ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision - mortality ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Oncology ; Prognosis ; Prospective Studies ; Sentinel Lymph Node Biopsy ; Surgery ; Surgical Oncology ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2012-06, Vol.19 (6), p.1959-1965</ispartof><rights>Society of Surgical Oncology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-77049ed8eaa0415ef9832def7f3ebdedeaf957f96e5312cc6867980de27beda33</citedby><cites>FETCH-LOGICAL-c372t-77049ed8eaa0415ef9832def7f3ebdedeaf957f96e5312cc6867980de27beda33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-012-2233-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-012-2233-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22322951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Viehl, Carsten T.</creatorcontrib><creatorcontrib>Guller, Ulrich</creatorcontrib><creatorcontrib>Cecini, Ramona</creatorcontrib><creatorcontrib>Langer, Igor</creatorcontrib><creatorcontrib>Ochsner, Alex</creatorcontrib><creatorcontrib>Terracciano, Luigi</creatorcontrib><creatorcontrib>Riehle, Hans-Martin</creatorcontrib><creatorcontrib>Laffer, Urban</creatorcontrib><creatorcontrib>Oertli, Daniel</creatorcontrib><creatorcontrib>Zuber, Markus</creatorcontrib><title>Sentinel Lymph Node Procedure Leads to Upstaging of Patients with Resectable Colon Cancer: Results of the Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
The value of the sentinel lymph node (SLN) procedure in colon cancer patients remains a matter of debate. The objective of this prospective, multicenter trial was 3-fold: to determine the identification rate and accuracy of the SLN procedure in patients with resectable colon cancer; to evaluate the learning curve of the SLN procedure; and to assess the extent of upstaging due to the SLN procedure.
Methods
One hundred seventy-four consecutive colon cancer patients were enrolled onto this prospective trial. They underwent an intraoperative SLN procedure with isosulfan blue 1% injected peritumorally followed by open standard colon resection with oncologic lymphadenectomy. Three levels of each SLN were stained with hematoxylin and eosin (H&E) and immunostained with the pancytokeratin marker AE1/AE3 if H&E was negative.
Results
SLN identification rate and accuracy were 89.1% and 83.9%, respectively. SLN were significantly more likely to contain tumor infiltrates than non-SLN (
P
< 0.001). Both SLN identification rate (
P
= 0.021) and the sensitivity of the procedure (
P
= 0.043) significantly improved with experience. The use of immunohistochemistry in SLN resulted in an upstaging of 15.4% (16 of 104) stage I and II patients considered node-negative in initial H&E analysis.
Conclusions
The SLN procedure for colon cancer has good identification and accuracy rates, which further improve with increasing experience. Most importantly, the SLN procedure results in upstaging of >15% of node-negative patients. The potential advantage of performing the SLN procedure appears to be particularly important in these patients because they may potentially benefit from adjuvant therapy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colonic Neoplasms - pathology</subject><subject>Colonic Neoplasms - surgery</subject><subject>Colorectal Cancer</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Node Excision - mortality</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUuP0zAUhS0EYh7wA9ggS2xYTMDvJOxQxUsqMKLMOnLtm9ajNA62w6j_jR_HLR0QIMHKls93zr3yIeQRZ8-4UPp55kxJVTEuKiGkrMwdcso1vijT8Lt4Z6apWmH0CTnL-ZoxXkum75MTpIVoNT8l31YwljDCQJf73bSlH6IHepmiAz8noEuwPtMS6dWUi92EcUNjTy9tCWjL9CaULf0EGVyx6wHoIg5xpAs7OkgvDsI8IIWOsgW6ugk5H7LzhHz4Chf0PerBYRQkuiqz39P_rxPGP0Y8IPd6O2R4eHuek6vXrz4v3lbLj2_eLV4uKydrUaq6ZqoF34C1THENfdtI4aGvewlrDx5s3-q6bw1oyYVzpjF12zAPol6Dt1Kek6fH3CnFLzPk0u1CdjAMdoQ4544zrrEPZRSiT_5Cr-OcRtzuB8U4b5VAih8ph7-RE_TdlMLOpj1C3aHa7lhth9V2h2o7g57Ht8nzegf-l-NnlwiII5BRGjeQfh_9r9TviP6xgg</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Viehl, Carsten T.</creator><creator>Guller, Ulrich</creator><creator>Cecini, Ramona</creator><creator>Langer, Igor</creator><creator>Ochsner, Alex</creator><creator>Terracciano, Luigi</creator><creator>Riehle, Hans-Martin</creator><creator>Laffer, Urban</creator><creator>Oertli, Daniel</creator><creator>Zuber, Markus</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Sentinel Lymph Node Procedure Leads to Upstaging of Patients with Resectable Colon Cancer: Results of the Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer</title><author>Viehl, Carsten T. ; Guller, Ulrich ; Cecini, Ramona ; Langer, Igor ; Ochsner, Alex ; Terracciano, Luigi ; Riehle, Hans-Martin ; Laffer, Urban ; Oertli, Daniel ; Zuber, Markus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-77049ed8eaa0415ef9832def7f3ebdedeaf957f96e5312cc6867980de27beda33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colonic Neoplasms - pathology</topic><topic>Colonic Neoplasms - surgery</topic><topic>Colorectal Cancer</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymph Node Excision - mortality</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Viehl, Carsten T.</creatorcontrib><creatorcontrib>Guller, Ulrich</creatorcontrib><creatorcontrib>Cecini, Ramona</creatorcontrib><creatorcontrib>Langer, Igor</creatorcontrib><creatorcontrib>Ochsner, Alex</creatorcontrib><creatorcontrib>Terracciano, Luigi</creatorcontrib><creatorcontrib>Riehle, Hans-Martin</creatorcontrib><creatorcontrib>Laffer, Urban</creatorcontrib><creatorcontrib>Oertli, Daniel</creatorcontrib><creatorcontrib>Zuber, Markus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Viehl, Carsten T.</au><au>Guller, Ulrich</au><au>Cecini, Ramona</au><au>Langer, Igor</au><au>Ochsner, Alex</au><au>Terracciano, Luigi</au><au>Riehle, Hans-Martin</au><au>Laffer, Urban</au><au>Oertli, Daniel</au><au>Zuber, Markus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sentinel Lymph Node Procedure Leads to Upstaging of Patients with Resectable Colon Cancer: Results of the Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>19</volume><issue>6</issue><spage>1959</spage><epage>1965</epage><pages>1959-1965</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
The value of the sentinel lymph node (SLN) procedure in colon cancer patients remains a matter of debate. The objective of this prospective, multicenter trial was 3-fold: to determine the identification rate and accuracy of the SLN procedure in patients with resectable colon cancer; to evaluate the learning curve of the SLN procedure; and to assess the extent of upstaging due to the SLN procedure.
Methods
One hundred seventy-four consecutive colon cancer patients were enrolled onto this prospective trial. They underwent an intraoperative SLN procedure with isosulfan blue 1% injected peritumorally followed by open standard colon resection with oncologic lymphadenectomy. Three levels of each SLN were stained with hematoxylin and eosin (H&E) and immunostained with the pancytokeratin marker AE1/AE3 if H&E was negative.
Results
SLN identification rate and accuracy were 89.1% and 83.9%, respectively. SLN were significantly more likely to contain tumor infiltrates than non-SLN (
P
< 0.001). Both SLN identification rate (
P
= 0.021) and the sensitivity of the procedure (
P
= 0.043) significantly improved with experience. The use of immunohistochemistry in SLN resulted in an upstaging of 15.4% (16 of 104) stage I and II patients considered node-negative in initial H&E analysis.
Conclusions
The SLN procedure for colon cancer has good identification and accuracy rates, which further improve with increasing experience. Most importantly, the SLN procedure results in upstaging of >15% of node-negative patients. The potential advantage of performing the SLN procedure appears to be particularly important in these patients because they may potentially benefit from adjuvant therapy.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22322951</pmid><doi>10.1245/s10434-012-2233-6</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2012-06, Vol.19 (6), p.1959-1965 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink |
| subjects | Adult Aged Aged, 80 and over Colonic Neoplasms - pathology Colonic Neoplasms - surgery Colorectal Cancer Female Follow-Up Studies Humans Lymph Node Excision - mortality Lymph Nodes - pathology Lymph Nodes - surgery Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Oncology Prognosis Prospective Studies Sentinel Lymph Node Biopsy Surgery Surgical Oncology Survival Rate |
| title | Sentinel Lymph Node Procedure Leads to Upstaging of Patients with Resectable Colon Cancer: Results of the Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer |
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