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    Sentinel nodes are identifiable in formalin-fixed specimens after surgeon-performed ex vivo sentinel lymph node mapping in colorectal cancer.

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    Authors
    Smith, Fraser McLean
    Coffey, 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
    2012-02-03T15:07:10Z
    MeSH
    Adenoma/*pathology
    Colorectal 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
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    Citation
    Ann Surg Oncol. 2005 Jun;12(6):504-9. Epub 2005 Apr 20.
    Journal
    Annals of surgical oncology
    URI
    http://hdl.handle.net/10147/208910
    DOI
    10.1245/ASO.2005.08.019
    PubMed ID
    15886906
    Abstract
    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
    eng
    ISSN
    1068-9265 (Print)
    1068-9265 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1245/ASO.2005.08.019
    Scopus Count
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    Cork University Hospital

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