Sentinel nodes are identifiable in formalin-fixed specimens after surgeon-performed ex vivo sentinel lymph node mapping in colorectal cancer.
Authors
Smith, Fraser McLeanCoffey, John Calvin
Khasri, Nurul Mod
Walsh, Miriam Fiona
Parfrey, Nollaig
Gaffney, Eoin
Stephens, Richard
Kennedy, M John
Kirwan, William
Redmond, H Paul
Affiliation
Departments of Academic Surgery and Pathology, Cork University Hospital, Wilton, , Cork, Ireland.Issue Date
2012-02-03T15:07:10ZMeSH
Adenoma/*pathologyColorectal Neoplasms/*pathology
Fixatives
Formaldehyde
Humans
Neoplasm Staging/*methods
Prospective Studies
Rosaniline Dyes/diagnostic use
Sensitivity and Specificity
Sentinel Lymph Node Biopsy/*methods
Specimen Handling
Tissue Fixation
Metadata
Show full item recordCitation
Ann Surg Oncol. 2005 Jun;12(6):504-9. Epub 2005 Apr 20.Journal
Annals of surgical oncologyDOI
10.1245/ASO.2005.08.019PubMed ID
15886906Abstract
BACKGROUND: In recent years, the technique of sentinel lymph node (SLN) mapping has been applied to colorectal cancer. One aim was to ultrastage patients who were deemed node negative by routine pathologic processing but who went on to develop systemic disease. Such a group may benefit from adjuvant chemotherapy. METHODS: With fully informed consent and ethical approval, 37 patients with primary colorectal cancer and 3 patients with large adenomas were prospectively mapped. Isosulfan blue dye (1 to 2 mL) was injected around tumors within 5 to 10 minutes of resection. After gentle massage to recreate in vivo lymph flow, specimens were placed directly into formalin. During routine pathologic analysis, all nodes were bivalved, and blue-staining nodes were noted. These later underwent multilevel step sectioning with hematoxylin and eosin and cytokeratin staining. RESULTS: SLNs were found in 39 of 40 patients (98% sensitivity), with an average of 4.1 SLNs per patient (range, 1-8). In 14 of 16 (88% specificity) patients with nodal metastases on routine reporting, SLN status was in accordance. Focused examination of SLNs identified occult tumor deposits in 6 (29%) of 21 node-negative patients. No metastatic cells were found in SLNs draining the three adenomas. CONCLUSIONS: The ability to identify SLNs after formalin fixation increases the ease and applicability of SLN mapping in colorectal cancer. Furthermore, the sensitivity and specificity of this simple ex vivo method for establishing regional lymph node status were directly comparable to those in previously published reports.Language
engISSN
1068-9265 (Print)1068-9265 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1245/ASO.2005.08.019
Scopus Count
Collections
Related articles
- Ex vivo sentinel lymph node mapping in colon cancer: improving the accuracy of pathologic staging?
- Authors: Smith J, Hwang H, Wiseman KW, Filipenko D, Phang PT
- Issue date: 2006 May
- Ex vivo lymphatic mapping: a technique to improve pathologic staging in colorectal cancer.
- Authors: Broderick-Villa G, Amr D, Haigh PI, O'Connell TX, Danial T, Difronzo LA
- Issue date: 2004 Nov
- [Mapping the sentinel lymph node ex vivo and finding the micrometastasis by CK-immunostaining in carcinoma of the colon and rectum].
- Authors: Wang FL, Pan ZZ, Wan DS
- Issue date: 2005 Aug 1
- Sentinel lymph node evaluation does not improve staging accuracy in colon cancer.
- Authors: Lim SJ, Feig BW, Wang H, Hunt KK, Rodriguez-Bigas MA, Skibber JM, Ellis V, Cleary K, Chang GJ
- Issue date: 2008 Jan
- Ex vivo sentinel lymph node mapping in patients undergoing proctectomy for rectal cancer.
- Authors: Finan KR, Lewis JS Jr, Winslow E, Mutch MG, Birnbaum EH, Fleshman JW
- Issue date: 2010 Mar