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Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer.

Kjölhede, Henrik LU ; Bratt, Ola LU ; Gudjonsson, Sigurdur LU ; Sundqvist, Pernilla and Liedberg, Fredrik LU (2015) In Scandinavian Journal of Urology2013-01-01+01:00 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)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
49
issue
2
pages
97 - 102
publisher
Taylor & Francis
external identifiers
  • pmid:25331366
  • wos:000351395600003
  • scopus:84924937614
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
2014-11-09 23:48:29
date last changed
2017-03-12 03:18:20
@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 Urology2013-01-01+01:00},
  title        = {Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer.},
  url          = {http://dx.doi.org/10.3109/21681805.2014.968867},
  volume       = {49},
  year         = {2015},
}