Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer.
(2015) In Scandinavian Journal of Urology 49(2). p.97-102- Abstract
- Abstract Objective. The reference standard for lymph-node staging in prostate cancer is currently an extended pelvic lymph-node dissection (ePLND), which detects most, but not all, regional lymph-node metastases. As an alternative to ePLND, sentinel-node dissection with preoperative isotope injection and imaging has been reported. The objective was to determine whether intraoperative sentinel-node detection with a simplified protocol can accurately determine lymph-node stage in prostate cancer patients. Materials and methods. Patients with biopsy-verified high-risk prostate cancer with tumour stage T2-3 were included in the study. All patients underwent both ePLND and sentinel-node detection. (99m)Tc-marked nanocolloid was injected... (More)
- Abstract Objective. The reference standard for lymph-node staging in prostate cancer is currently an extended pelvic lymph-node dissection (ePLND), which detects most, but not all, regional lymph-node metastases. As an alternative to ePLND, sentinel-node dissection with preoperative isotope injection and imaging has been reported. The objective was to determine whether intraoperative sentinel-node detection with a simplified protocol can accurately determine lymph-node stage in prostate cancer patients. Materials and methods. Patients with biopsy-verified high-risk prostate cancer with tumour stage T2-3 were included in the study. All patients underwent both ePLND and sentinel-node detection. (99m)Tc-marked nanocolloid was injected peritumourally by the operating urologist after induction of anaesthesia just before surgery. Sentinel nodes were detected both in vivo and ex vivo intraoperatively using a gamma probe. Sentinel nodes and metastases and their locations were recorded. Sensitivity and specificity were calculated. Results. At least one sentinel node was detected in 72 (87%) of the 83 patients. In 13 (18%) of these 72 patients sentinel nodes were detected outside the ePLND template. In six of these 13 patients, the Sentinel nodes from outside the template contained metastases, which proved to be the only metastases in two. For 12 patients the only metastatic deposit found was a micrometastasis (≤2 mm) in a sentinel node. In the 72 patients with detectable sentinel nodes, pathological analysis of the sentinel node correctly categorized 71 and ePLND 70 patients. Conclusions. This protocol yielded results comparable to the commonly used technique of sentinel-node detection, but with more cases of non-detection. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4733726
- author
- Kjölhede, Henrik LU ; Bratt, Ola LU ; Gudjonsson, Sigurdur LU ; Sundqvist, Pernilla and Liedberg, Fredrik LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Urology
- volume
- 49
- issue
- 2
- pages
- 97 - 102
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:25331366
- wos:000351395600003
- scopus:84924937614
- pmid:25331366
- ISSN
- 2168-1813
- DOI
- 10.3109/21681805.2014.968867
- language
- English
- LU publication?
- yes
- id
- ddd56148-79d5-4e76-bef6-2e25df50bdbd (old id 4733726)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/25331366?dopt=Abstract
- date added to LUP
- 2016-04-01 11:00:47
- date last changed
- 2022-04-12 19:47:57
@article{ddd56148-79d5-4e76-bef6-2e25df50bdbd,
abstract = {{Abstract Objective. The reference standard for lymph-node staging in prostate cancer is currently an extended pelvic lymph-node dissection (ePLND), which detects most, but not all, regional lymph-node metastases. As an alternative to ePLND, sentinel-node dissection with preoperative isotope injection and imaging has been reported. The objective was to determine whether intraoperative sentinel-node detection with a simplified protocol can accurately determine lymph-node stage in prostate cancer patients. Materials and methods. Patients with biopsy-verified high-risk prostate cancer with tumour stage T2-3 were included in the study. All patients underwent both ePLND and sentinel-node detection. (99m)Tc-marked nanocolloid was injected peritumourally by the operating urologist after induction of anaesthesia just before surgery. Sentinel nodes were detected both in vivo and ex vivo intraoperatively using a gamma probe. Sentinel nodes and metastases and their locations were recorded. Sensitivity and specificity were calculated. Results. At least one sentinel node was detected in 72 (87%) of the 83 patients. In 13 (18%) of these 72 patients sentinel nodes were detected outside the ePLND template. In six of these 13 patients, the Sentinel nodes from outside the template contained metastases, which proved to be the only metastases in two. For 12 patients the only metastatic deposit found was a micrometastasis (≤2 mm) in a sentinel node. In the 72 patients with detectable sentinel nodes, pathological analysis of the sentinel node correctly categorized 71 and ePLND 70 patients. Conclusions. This protocol yielded results comparable to the commonly used technique of sentinel-node detection, but with more cases of non-detection.}},
author = {{Kjölhede, Henrik and Bratt, Ola and Gudjonsson, Sigurdur and Sundqvist, Pernilla and Liedberg, Fredrik}},
issn = {{2168-1813}},
language = {{eng}},
number = {{2}},
pages = {{97--102}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Urology}},
title = {{Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer.}},
url = {{https://lup.lub.lu.se/search/files/2306243/7791801.pdf}},
doi = {{10.3109/21681805.2014.968867}},
volume = {{49}},
year = {{2015}},
}