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dc.contributor.authorSmith, Fraser McLean
dc.contributor.authorCoffey, John Calvin
dc.contributor.authorKhasri, Nurul Mod
dc.contributor.authorWalsh, Miriam Fiona
dc.contributor.authorParfrey, Nollaig
dc.contributor.authorGaffney, Eoin
dc.contributor.authorStephens, Richard
dc.contributor.authorKennedy, M John
dc.contributor.authorKirwan, William
dc.contributor.authorRedmond, H Paul
dc.date.accessioned2012-02-03T15:07:10Z
dc.date.available2012-02-03T15:07:10Z
dc.date.issued2012-02-03T15:07:10Z
dc.identifier.citationAnn Surg Oncol. 2005 Jun;12(6):504-9. Epub 2005 Apr 20.en_GB
dc.identifier.issn1068-9265 (Print)en_GB
dc.identifier.issn1068-9265 (Linking)en_GB
dc.identifier.pmid15886906en_GB
dc.identifier.doi10.1245/ASO.2005.08.019en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208910
dc.description.abstractBACKGROUND: 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.
dc.language.isoengen_GB
dc.subject.meshAdenoma/*pathologyen_GB
dc.subject.meshColorectal Neoplasms/*pathologyen_GB
dc.subject.meshFixativesen_GB
dc.subject.meshFormaldehydeen_GB
dc.subject.meshHumansen_GB
dc.subject.meshNeoplasm Staging/*methodsen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshRosaniline Dyes/diagnostic useen_GB
dc.subject.meshSensitivity and Specificityen_GB
dc.subject.meshSentinel Lymph Node Biopsy/*methodsen_GB
dc.subject.meshSpecimen Handlingen_GB
dc.subject.meshTissue Fixationen_GB
dc.titleSentinel nodes are identifiable in formalin-fixed specimens after surgeon-performed ex vivo sentinel lymph node mapping in colorectal cancer.en_GB
dc.contributor.departmentDepartments of Academic Surgery and Pathology, Cork University Hospital, Wilton, , Cork, Ireland.en_GB
dc.identifier.journalAnnals of surgical oncologyen_GB
dc.description.provinceMunster
html.description.abstractBACKGROUND: 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.


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