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Tran, Bao Ngoc N., Arthur R. Celestin, Bernard T. Lee, Jonathan Critchlow, Leo Tsai, Beau Toskich, and Dhruv Singhal. "Quantifying Lymph Nodes During Lymph Node Transplantation." Annals of Plastic Surgery 81, no. 6 (December 2018): 675–78. http://dx.doi.org/10.1097/sap.0000000000001571.
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Strauchen, James A., and Lorraine K. Miller. "Lymph Node Infarction." Archives of Pathology & Laboratory Medicine 127, no. 1 (January 1, 2003): 60–63. http://dx.doi.org/10.5858/2003-127-60-ln.
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Abstract Context.—The etiology of lymph node infarction may be difficult or impossible to determine by histologic examination. Lymph node infarction is followed by malignant lymphoma in some but not all patients. The role of immunohistochemistry in the evaluation of lymph node infarction is not well defined. Although it is widely believed that necrotic tissue is not suitable for immunohistochemical study, this view may be inaccurate. Objective.—To determine whether lymphoid antigens are preserved in infarcted lymph nodes and to determine the utility of immunohistochemical staining in the evaluation of lymph node infarction. Design.—Retrospective immunohistochemical study of infarcted lymph nodes using archival formalin-fixed, paraffin-embedded tissue. Setting.—Academic medical center. Patients.—Eleven adult patients with lymph node infarction retrieved from pathology files. Main Outcome Measures.—Results of immunohistochemistry, diagnosis of lymphoma. Results.—Preservation of lymphoid antigens was observed in 4 of 6 cases of lymph node infarction associated with malignant lymphoma, including 3 of 5 cases of diffuse large B-cell lymphoma and 1 case of peripheral T-cell lymphoma. Nonspecific staining was not encountered. In 1 case, in which an infarcted lymph node showed a benign pattern of lymphoid antigen expression, lymphoma has not developed after 5 years. Conclusion.—Lymphoid antigens are frequently preserved in cases of lymph node infarction, and immunohistochemical study of infarcted lymph nodes may provide clinically useful information.
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Li, Jiancheng, and Xiuling Shi. "PS02.131: PATTERN OF LYMPHATIC METASTASIS OF CERVICAL ESOPHAGEAL CANCER." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 158. http://dx.doi.org/10.1093/dote/doy089.ps02.131.
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Abstract Background Cervical esophageal cancer were rarely surgeryed Analysis and discussion of lymph node metastasis of cervical esophageal cancer Methods From July 2008 to June 2017, 10 cases of successful esophagectomy of cervical esophageal cance in our hospital underwent radical resection. Surgical dissection range was the neck and the upper mediastinum. A total of 231 lymph nodes were dissected. The lymph nodes were summarized and grouped in different ways, and analyzed the law of lymph node metastasis. Results 7 cases of esophageal cancer, lymph node metastasis occurred, and the rate of lymph node metastasis was 70% (7/10), of which 1 case was T1b stage. 17 lymph node metastases, the degree of lymph node metastasis was 7.36% (17/231), including 4 esophageal lymph nodes, 12 cervical lymph nodes and 1 upper right mediastinal lymph node. Conclusion Cervical esophageal cancer lymph node metastasis can spread occur early metastasis, and the metastasis site were mainly in neck.. Disclosure All authors have declared no conflicts of interest.
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Suciu, Nicolae, Orsolya Bauer, Zalán Benedek, Radu Ghenade, Marius Coroș, and Rareș Georgescu. "Study of Survival in Gastric Cancer with Emphasis on Lymph Node Status as an Independent Prognostic Factor." Journal of Interdisciplinary Medicine 4, no. 4 (December 1, 2019): 185–89. http://dx.doi.org/10.2478/jim-2019-0031.
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Abstract Background: Lymph node status in gastric cancer is known as an independent prognostic factor that guides the surgical and oncological treatment and independently influences long-term survival. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes. Aim: The aim of this study was to evaluate the clinical and morphological factors that can influence the survival of gastric cancer patients, with an emphasis on nodal status and the lymph node ratio. Material and methods: We conducted a retrospective study in which 303 patients with gastric cancer admitted to the Department of Surgery of the Mureș County Hospital between 2008 and 2018 were screened for study enrolment. Data were obtained from the records of the department and from the histopathological reports. The examined variables included: age, gender, tumor localization, T stage, histological type, grade of differentiation, surgical procedure, lympho-vascular invasion, excised lymph nodes, metastatic lymph nodes, lymph node ratio. After screening, the study included a total number of 100 patients, for which follow-up data was available. Results: The mean age of the study population was 66.43 ± 10 years, and 71% were males. The average survival period was 21.42 months. Statistical analysis showed that the localization of the tumor (p = 0.021), vascular invasion (p ---lt---0.001), T (p = 0.004) and N (p ---lt---0.001) stages, type of surgery (partial gastrectomy 59% vs. total gastrectomy 41%, p = 0.005), as well as the lymph node ratio (p ---lt---0.001) were prognostic factors for survival in patients with gastric cancer undergoing surgical therapy. Conclusions: The survival of gastric cancer patients is significantly influenced by tumor localization, T stage, vascular invasion, type of surgery, N stage and the lymph node ratio based on univariate analysis. Also, the lymph node ratio proved to be an independent prognostic factor for survival.
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Leibold, Tobias, Jinru Shia, Leyo Ruo, Bruce D. Minsky, Timothy Akhurst, Marc J. Gollub, Michelle S. Ginsberg, et al. "Prognostic Implications of the Distribution of Lymph Node Metastases in Rectal Cancer After Neoadjuvant Chemoradiotherapy." Journal of Clinical Oncology 26, no. 13 (May 1, 2008): 2106–11. http://dx.doi.org/10.1200/jco.2007.12.7704.
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Purpose After preoperative chemoradiotherapy of rectal cancer, the number of retrievable and metastatic lymph nodes is decreased. The current TNM classification is based on number and not location of lymph node metastases and may understage disease after chemoradiotherapy. The aim of this study was to examine the prognostic significance of location of involved lymph nodes in rectal cancer patients after preoperative chemoradiotherapy. Patients and Methods We prospectively examined whole-mount specimens from 121 patients with uT3-4 and/or N+ rectal cancer who received preoperative chemoradiotherapy followed by resection. Location of involved lymph nodes was compared with median number of lymph nodes involved as well as presence of distant metastasis at presentation. Results Lymph node metastases were detected in 37 patients (31%). Thirteen patients with lymph node involvement along major supplying vessels (proximal lymph node metastases) had a significantly higher rate of distant metastatic disease at time of surgery than patients without proximal lymph node involvement (P < .001); median number of lymph nodes involved was two for patients with proximal lymph node metastases and 1.5 for patients with mesorectal lymph node involvement alone. Conclusion Our data suggest that, after preoperative chemoradiotherapy, proximal lymph node involvement is associated with a high incidence of metastatic disease at time of surgery. Because the median number of involved lymph nodes is low after preoperative chemoradiotherapy, the TNM staging system may not provide an accurate assessment of metastatic disease. Therefore, the ypTNM staging system should incorporate distribution as well as number of lymph node metastases after preoperative chemoradiotherapy for rectal cancer.
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Picciotto, Franco, Gianluca Avallone, Federico Castellengo, Martina Merli, Virginia Caliendo, Rebecca Senetta, Adriana Lesca, et al. "Non-Sentinel Lymph Node Detection during Sentinel Lymph Node Biopsy in Not-Complete-Lymph-Node-Dissection Era: A New Technique for Better Staging and Treating Melanoma Patients." Journal of Clinical Medicine 10, no. 19 (September 23, 2021): 4319. http://dx.doi.org/10.3390/jcm10194319.
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Sentinel lymph node biopsy has been demonstrated to be an effective staging procedure since its introduction in 1992. The new American Joint Committee on Cancer (AJCC) classification did not consider the lack of information that would result from the less usage of the complete lymph node dissection as for a diagnostic purpose. Thus, this makes it difficult the correct staging and would leave about 20% of the further positive non-sentinel lymph nodes in the lymph node basin. In this paper, we aim to describe a new surgical technique that, combined with single-photon emission computed tomography-computed tomography (SPECT-CT), allows for better staging of melanoma patients. This is a prospective study that includes 104 patients with cutaneous melanoma. Sentinel lymph node biopsy was offered according to the AJCC guideline. Planar lymphoscintigraphy was performed in association with SPECT-CT, identifying and removing all non-biologically “excluded” lymph nodes, guiding the surgeon’s hand in detection and removal of lymph nodes. Even if identification and removal of non-sentinel lymph nodes is unable to increase overall survival, it definitely gives better disease control in the basin. With a “classic” setting, the risk of leaving further lymph nodes out of the sentinel lymph node procedure is around 20%, thus, basically, the surgical sentinel lymph node of first and second lymph nodes would have therapeutic value and complete lymph node dissection classically performed.
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Vogt, H., R. Bares, W. Brenner, F. Grünwald, J. Kopp, C. Reiners, O. Schober, et al. "Verfahrensanweisung für die nuklear medizinische Wächter-Lymphknoten-Diagnostik." Nuklearmedizin 49, no. 04 (2010): 167–72. http://dx.doi.org/10.3413/nukmed-321.
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SummaryThe authors present a procedure guideline for scintigraphic detection of sentinel lymph nodes in malignant melanoma and other skin tumours, in breast cancer, in head and neck cancer, and in prostate and penile carcinoma. Important goals of sentinel lymph node scintigraphy comprise reduction of the extent of surgery, lower postoperative morbidity and optimization of histopathological examination focussing on relevant lymph nodes. Sentinel lymph node scintigraphy itself does not diagnose tumorous lymph node involvement and is not indicated when lymph node metastases have been definitely diagnosed before sentinel lymph node scintigraphy. Procedures are compiled with the aim to reliably localise sentinel lymph nodes with a high detection rate typically in early tumour stages. Radiation exposure is low so that pregnancy is not a contraindication for sentinel lymph node scintigraphy. Even with high volumes of scintigraphic sentinel lymph node procedures surgeons, theatre staff and pathologists receive a radiation exposure < 1 mSv/year so that they do not require occupational radiation surveillance.
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Euscher, Elizabeth. "Pathology of sentinel lymph nodes: historical perspective and current applications in gynecologic cancer." International Journal of Gynecologic Cancer 30, no. 3 (February 19, 2020): 394–401. http://dx.doi.org/10.1136/ijgc-2019-001022.
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Efforts to reduce surgical morbidity related to en bloc lymph node removal associated with cancer surgery led to the development of targeted lymph node sampling to identify the lymph node(s) most likely to harbor a metastasis. Through identification of one or only a few lymph nodes at highest risk, the overall number of lymph nodes removed could be markedly reduced. Submission of fewer lymph nodes affords more detailed pathologic examination than would otherwise be practical with a standard lymph node dissection. Such enhanced pathologic examination techniques (ie, ultra-staging) have contributed to increased detection of lymph node metastases, primarily by detection of low volume metastatic disease. Based on the success of sentinel lymph node mapping and ultra-staging in breast cancer and melanoma, such techniques are increasingly used for other organ systems including the gynecologic tract. This review addresses the historical aspects of sentinel lymph node evaluation and reviews current ultra-staging protocols as well as the implications associated with increased detection of low volume metastases.
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Harold, J. A., D. Uyar, J. S. Rader, E. Bishop, M. Nugent, P. Simpson, and W. H. Bradley. "Adipose-only sentinel lymph nodes: a finding during the adaptation of a sentinel lymph node mapping algorithm with indocyanine green in women with endometrial cancer." International Journal of Gynecologic Cancer 29, no. 1 (January 2019): 53–59. http://dx.doi.org/10.1136/ijgc-2018-000008.
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ObjectiveTo identify factors that affect successful adaptation of sentinel lymph node mapping and those that lead to unintended adipose-only sentinel lymph node identification.MethodsSurgical and pathological data were prospectively collected on patients with endometrial cancer who underwent sentinel lymph node mapping with indocyanine green with or without pelvic and/or para-aortic lymph node dissection between November 2013 and April 2017. All mapping cases were performed with the robotic system. Adipose-only specimens were defined as a sentinel lymph node without a pathologically identified lymph node after ultrastaging.ResultsA total of 202 patients were included: 83% had endometrioid pathology, 12% serous, 3% carcinosarcoma, and 2% clear cell, with mixed pathology noted in 2%. The bilateral sentinel lymph node detection rate was 66%, and the rate of mapping at least a unilateral sentinel lymph node was 86%. Neither the bilateral nor the unilateral sentinel lymph node mapping rate changed with increased surgeon experience. The rate of adipose-only sentinel lymph node identification was more frequent when comparing the first 10 cases (37%), cases 11 – 30 (28%), and > 30 cases (9%) (P = 0.006). Body mass index > 30 kg/m2, uterine fibroids, The International Federation of Gynecology and Obstetrics (FIGO) grade, and histology were not found to have a statistically significant impact on either sentinel lymph node identification or adipose-only sentinel lymph node identification. Adipose-only sentinel lymph nodes were more likely with increased time from cervical injection to identification of the sentinel lymph node in the right hemipelvis. The median range was 28 min (14–73) for true sentinel lymph node identification vs 33 min (23–74) for adipose-only sentinel lymph node identification (P = 0.02).ConclusionPatient and surgeon factors did not impact the identification of sentinel lymph nodes over time. Adipose-only sentinel lymph nodes were more frequently identified in the initial cases and represent a potential complication to adapting sentinel lymph node biopsy without lymphadenectomy. The increase in adipose-only sentinel lymph node identification that was associated with time from cervical injection may represent delayed or disrupted uptake of indocyanine green.
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Vrancken Peeters, Marie-Jeanne TFD, Marieke Evelien Straver, Mila Donker, Claudette Loo, Gabe S. Sonke, Jelle Wesseling, and Emiel J. Rutgers. "Novel surgical technique to selectively remove metastatic axillary lymph nodes in breast cancer patients after neoadjuvant chemotherapy: The MARI procedure—Marking of the axilla with radioactive iodine seeds." Journal of Clinical Oncology 30, no. 27_suppl (September 20, 2012): 196. http://dx.doi.org/10.1200/jco.2012.30.27_suppl.196.
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196 Background: An important benefit of neoadjuvant chemotherapy (NAC) is the increase in breast-conserving surgery. At present the response of axillary lymph node metastases to chemotherapy cannot be accurately assessed. Therefore axilla-conserving therapy is not yet a benefit. We aimed to assess a new surgical method to evaluate the axillary response: the MARI procedure, which stands for Marking of the Axillary lymph node with Radioactive Iodine seeds. Methods: Prior to NAC, proven tumor-positive axillary lymph nodes were marked with a Iodine-125 seed. After NAC, the marked lymph node was selectively removed with the use of a gamma-detection probe. A complementary axillary lymph node dissection was performed to assess whether pathological response in the marked node was indicative for the pathological response in the additional lymph nodes. Results: Tumor-positive axillary lymph nodes were successfully marked with Iodine-125 seeds in 68 patients. The marked lymph node (MARI-node) was surgically detected and selectively removed after NAC in all patients. The pathological response to chemotherapy in the MARI-node was indicative for the overall response in the additionally removed lymph nodes. In 47 patients the MARI-node contained residual disease (n=45 macrometastasis, n= 2 ITC). Thirty-five of them had macro- or micro metastases in the complementary axillary lymph node dissection specimen. In 21 patients the MARI-node was tumor negative. In 2 patients a macro metastasis was found in the additionally removed nodes, in 2 patients ITC were found and in the remaining 17 patients no residual tumor was found in the additionaly removed lymphnodes. (false negative rate of the MARI procedure: 9.5%). Conclusions: This study shows that marking and selectively removing metastatic lymph nodes after NAC is feasible. The tumor-response in the marked lymph node may be used to tailor further axillary treatment, and herewith enabling axilla-conserving surgery after neoadjuvant chemotherapy.
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Herring, Erin S., Mark M. Smith, and John L. Robertson. "Lymph Node Staging of Oral and Maxillofacial Neoplasms in 31 Dogs and Cats." Journal of Veterinary Dentistry 19, no. 3 (September 2002): 122–26. http://dx.doi.org/10.1177/089875640201900301.
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A retrospective study was performed to report the histologic examination results of regional lymph nodes of dogs and cats with oral or maxillofacial neoplasms. Twenty-eight dogs and 3 cats were evaluated. Histologic examination results of standard and serial tissue sectioning of regional lymph nodes were recorded. When available, other clinical parameters including mandibular lymph node palpation, thoracic radiographs, and pre- and postoperative fine needle aspiration of lymph nodes were compared with the histologic results. Squamous cell carcinoma, fibrosarcoma, and melanoma were the most common neoplasms diagnosed in dogs. Squamous cell carcinoma and fibrosarcoma were diagnosed in cats. Of the palpably enlarged mandibular lymph nodes, 17.0 % had metastatic disease histologically. Radiographically evident thoracic metastatic disease was present in 7.4 % of cases. Preoperative cytologic evaluation of the mandibular lymph node based on fine needle aspiration concurred with the histologic results in 90.5 % of lymph nodes examined. Postoperative cytologic evaluation of fine needle aspirates of regional lymph nodes concurred with the histologic results in 80.6 % of lymph nodes examined. Only 54.5 % of cases with metastatic disease to regional lymph nodes had metastasis that included the mandibular lymph node. Serial lymph node sectioning provided additional information or metastasis detection. Cytologic evaluation of the mandibular lymph node correlates positively with histology, however results may fail to indicate the presence of regional metastasis. Assessment of all regional lymph nodes in dogs and cats with oral or maxillofacial neoplasms will detect more metastatic disease than assessing the mandibular lymph node only.
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Olaya, Windy, Jasmine Wong, Jan Wong, John Morgan, Kevork Kazanjian, and Sharon Lum. "When is a Lymph Node Dissection a Lymph Node Dissection? The Number of Lymph Nodes Resected in Sentinel and Axillary Lymph Node Dissections." Annals of Surgical Oncology 20, no. 2 (September 7, 2012): 627–32. http://dx.doi.org/10.1245/s10434-012-2642-6.
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Vega, Eduardo A., Eduardo Vinuela, Gabriel Cavada, Marcel P. Sanhueza, and Claudius Conrad. "Lymph Node Status in Incidental Gallbladder Cancer: Cystic Duct Lymph Node, Lymph Node Dissection and Number of Metastatic Lymph Node." Gastroenterology 152, no. 5 (April 2017): S1209. http://dx.doi.org/10.1016/s0016-5085(17)34023-4.
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Krivorotko, Petr, Alexander Emelyanov, Alexander Komyahov, Elena Zhiltsova, Larisa Gigolaeva, Tengiz Tabagua, Kirill Nikolaev, et al. "Axillary surgery after neoadjuvant chemotherapy in breast cancer patients downstaging from cN+ to ycN0." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e12580-e12580. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e12580.
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e12580 Background: Axillary lymph node dissection is a redundant method of surgical treatment and axillary staging for a large number of patients receiving neoadjuvant therapy with positive lymph nodes before NCT. Methods: The study included 212 patients with breast cancer (cT1-3N1M0) who received treatment at the breast tumors department of the N.N. Petrov NMRC of Oncology from 2019 to 2021 All patients included in the study had the cN1 initial status of the axillary lymph nodes. All patients underwent neoadjuvant systemic therapy and subsequent sentinel lymph node biopsy (SLNB). In patients with pathomorphologically proven metastatic lymph nodes (cN1) even at the initial diagnosis, lymph node marking was performed before the start of NCT and targeted axillary lymph node dissection after the completion of neoadjuvant systemic therapy. In the same patients, after SLNB and targeted axillary lymph node dissection, a complete (standard) axillary lymph node dissection was performed to determine the false-negative rate and the oncological safety of the procedure. Results: The identification rate of only one sentinel lymph node was 21% (40 out of 193 patients), two sentinel lymph nodes - 30% (58 out of 193 patients), more than 3 - 49% (95 out of 193 patients). When only 1 sentinel lymph node was found, the false-negative rate of SLNB was 20.0% (4 of 20) (95% CI, 5.7 to 43.7). When two sentinel lymph nodes were found, the false-negative rate of SLNB was 20.0% (6 of 30) (95% CI, 7.7 to 38.6). When three sentinel lymph nodes were found, the false negative rate of SLNB was 4.7% (2 of 43) (95% CI, 0 to 15.8). Among 45 patients who had a microseed with the iodine-125 radioisotope installed before the start of treatment, the frequency of identifying a marked node was 100%. In 19 patients, tumor cells were found in the lymph nodes. The false-negative rate of targeted axillary dissection in combination with SLNB was 5.3% (1 of 19) (95% CI, 0 to 26.0). Conclusions: Targeted axillary dissection and sentinel lymph nodes biopsy, provided that 3 SLNs are removed, are reliable methods for identifying patients in whom systemic therapy is guaranteed to achieve complete response of regional lymph nodes (ypN0), thereby relieving patients of the need to perform a crippling complete axillary lymph node dissection. Clinical trial information: 3/198.
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Aning, J. J., R. Thurairaja, D. A. Gillatt, A. J. Koupparis, E. W. Rowe, and J. Oxley. "Pathological analysis of lymph nodes in anterior prostatic fat excised at robot-assisted radical prostatectomy." Journal of Clinical Pathology 67, no. 9 (July 4, 2014): 787–91. http://dx.doi.org/10.1136/jclinpath-2014-202303.
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AimsTo assess the lymph node content of anterior prostatic fat (APF) sent routinely at robot-assisted laparoscopic radical prostatectomy (RALP) and the incidence of positive nodes in the extended pelvic lymph node dissection.MethodsBetween September 2008 and April 2012, APF excised from 282 patients who underwent RALP was sent for pathological analysis. This tissue was completely embedded and lymph nodes counted.ResultsIn total, 49/282 (17%) patients had lymph nodes in the APF, median lymph node yield in this tissue was 1 (range 1–5). In four patients, the lymph nodes contained metastatic deposits. These patients did not have positive nodes elsewhere in the extended lymph node dissection.ConclusionsAPF contains lymph nodes in 1 in 6 patients and infrequently these may be malignant. APF should always be removed at radical prostatectomy. APF should be routinely sent for pathological analysis.
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Chiu, Wan Kam, Shuk Tak Kwok, Yaokai Wang, Hiu Mei Luk, Aaron Hei Yin Chan, and Ka Yu Tse. "Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer." Journal of Clinical Medicine 11, no. 21 (October 31, 2022): 6462. http://dx.doi.org/10.3390/jcm11216462.
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Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality of life of the patients. The sentinel lymph node is the first lymph node that tumor cells drain to, and sentinel lymph node biopsy has emerged as an acceptable alternative to full lymphadenectomy in both low-risk and high-risk endometrial cancer. Evidence has demonstrated a high detection rate, sensitivity and negative predictive value of sentinel lymph node biopsy. It can also reduce surgical morbidity and improve the detection of lymph node metastases compared with systematic lymphadenectomy. This review summarizes the current techniques of sentinel lymph node mapping, the applications and oncological outcomes of sentinel lymph node biopsy in low-risk and high-risk endometrial cancer, and the management of isolated tumor cells in sentinel lymph nodes. We also illustrate a revised sentinel lymph node biopsy algorithm and advocate to repeat the tracer injection and explore the presacral and paraaortic areas if sentinel lymph nodes are not found in the hemipelvis.
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Maguire, Aoife, and Edi Brogi. "Sentinel Lymph Nodes for Breast Carcinoma: A Paradigm Shift." Archives of Pathology & Laboratory Medicine 140, no. 8 (August 1, 2016): 791–98. http://dx.doi.org/10.5858/arpa.2015-0140-ra.
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Context.—Sentinel lymph node biopsy has been established as the new standard of care for axillary staging in most patients with invasive breast carcinoma. Historically, all patients with a positive sentinel lymph node biopsy result underwent axillary lymph node dissection. Recent trials show that axillary lymph node dissection can be safely omitted in women with clinically node negative, T1 or T2 invasive breast cancer treated with breast-conserving surgery and whole-breast radiotherapy. This change in practice also has implications on the pathologic examination and reporting of sentinel lymph nodes.Objective.—To review recent clinical and pathologic studies of sentinel lymph nodes and explore how these findings influence the pathologic evaluation of sentinel lymph nodes.Data Sources.—Sources were published articles from peer-reviewed journals in PubMed (US National Library of Medicine) and published guidelines from the American Joint Committee on Cancer, the Union for International Cancer Control, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network.Conclusions.—The main goal of sentinel lymph node examination should be to detect all macrometastases (>2 mm). Grossly sectioning sentinel lymph nodes at 2-mm intervals and evaluation of one hematoxylin-eosin–stained section from each block is the preferred method of pathologic evaluation. Axillary lymph node dissection can be safely omitted in clinically node-negative patients with negative sentinel lymph nodes, as well as in a selected group of patients with limited sentinel lymph node involvement. The pathologic features of the primary carcinoma and its sentinel lymph node metastases contribute to estimate the extent of non–sentinel lymph node involvement. This information is important to decide on further axillary treatment.
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Demirtaş, Abdullah, Volkan Sabur, Emre Can Akınsal, Deniz Demirci, Oguz Ekmekcioglu, Ibrahim Gulmez, and Atila Tatlisen. "Can Neutrophil-Lymphocyte Ratio and Lymph Node Density Be Used as Prognostic Factors in Patients Undergoing Radical Cystectomy?" Scientific World Journal 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/703579.
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Objective. To assessment the role of preoperative neutrophil-lymphocyte ratio and postoperative lymph node density in predicting prognosis in patients undergoing radical cystectomy for bladder cancer.Material and Methods. Preoperatively, neutrophil and lymphocyte counts as well as neutrophil-lymphocyte ratios were recorded in 201 patients who underwent radical cystectomy for bladder cancer. Patients with an infection were excluded. Based on the pathology reports, the number of positive lymph nodes was divided by the total number of lymph nodes to calculate lymph node density.Results. The mean follow-up duration was months in patients without lymph node involvement and months in those with lymph node involvement (). Median lymph node density was 17% (4–80) in patients with lymph node involvement. There was no difference according to lymph node density lower than 17% and greater than 17% . There was no significant difference between patients with an NLR below or above 2.5 in terms of overall survival (). Pathological T stage was associated with survival ().Conclusion. In patients undergoing RC for bladder cancer, lymph node density and preoperative NLR were not found to be independent predictors of prognosis.
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de Hullu, J. A., H. Hollema, D. A. Piers, R. H. M. Verheijen, P. J. van Diest, M. J. E. Mourits, J. G. Aalders, and A. G. J. van der Zee. "Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva." Journal of Clinical Oncology 18, no. 15 (August 15, 2000): 2811–16. http://dx.doi.org/10.1200/jco.2000.18.15.2811.
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PURPOSE: To determine the diagnostic accuracy of the sentinel lymph node procedure in patients with squamous cell carcinoma of the vulva and to investigate whether step sectioning and immunohistochemistry of sentinel lymph nodes increase the sensitivity for detection of metastases. PATIENTS AND METHODS: Between July 1996 and July 1999, 59 patients with primary vulvar cancer were entered onto a two-center prospective study. All patients underwent sentinel lymph node procedure with the combined technique (preoperative lymphoscintigraphy with technetium-99m–labeled nanocolloid and intraoperative blue dye). Radical excision of the primary tumor with uni- or bilateral inguinofemoral lymphadenectomy was performed subsequently. Sentinel lymph nodes and lymphadenectomy specimens were sent for histopathologic examination separately. Sentinel lymph nodes, negative at the time of routine pathologic examination, were re-examined with step sectioning and immunohistochemistry. RESULTS: In 59 patients, 107 inguinofemoral lymphadenectomies were performed (11 unilateral and 48 bilateral). All sentinel lymph nodes, as observed on preoperative lymphoscintigram, were identified successfully intraoperatively. Routine histopathologic examination showed lymph node metastases in 27 groins, all of which were detected by the sentinel lymph node procedure. The negative predictive value for a negative sentinel lymph node was 100% (97.5% confidence interval [CI], 95% to 100%). Step sectioning and immunohistochemistry showed four additional metastases in 102 sentinel lymph nodes (4%; 95% CI, 1% to 9%) that were negative at the time of routine histopathologic examination. CONCLUSION: Sentinel lymph node procedure with the combined technique is highly accurate in predicting the inguinofemoral lymph node status in patients with early-stage vulvar cancer. Future trials should focus on the safe clinical implementation of the sentinel lymph node procedure in these patients. Step sectioning and immunohistochemistry slightly increase the sensitivity of detecting metastases in sentinel lymph nodes and should be included in these trials.
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Lin, Y. S., C. C. Tzeng, K. F. Huang, C. Y. Kang, C. C. Chia, and J. F. Hsieh. "Sentinel node detection with radiocolloid lymphatic mapping in early invasive cervical cancer." International Journal of Gynecologic Cancer 15, no. 2 (2005): 273–77. http://dx.doi.org/10.1136/ijgc-00009577-200503000-00014.
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We assessed the feasibility of sentinel lymph node detection using technicium-99 radiocolloid lymphatic mapping for predicting lymph node metastases in early invasive cervical cancer. Thirty patients with cervical cancer (stages IA2–IIA) underwent preoperative lymphoscintigraphy using technicium-99 intracervical injection and intraoperative lymphatic mapping with a handheld gamma probe. After dissection of the sentinel nodes, the standard procedure of pelvic lymph node dissection and radical hysterectomy was performed as usual. The sentinel node detection rate was 100% (30/30). There were seven (23.3%) cases of microscopic lymph node metastases on pathologic analysis. All of them had sentinel node involvement. Therefore, the sensitivity of sentinel node identification for prediction of lymph node metastases was 100%, and no false negative was found. Preoperative lymphoscintigraphy, coupled with intraoperative lymphatic mapping, located the sentinel nodes accurately in our study patients. This sentinel node detection method appears to be feasible for predicting lymph node metastases
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Park, Su Youn, Byung-Soo Chang, Seung Hwan Lee, Ju Hwan Yoon, Sungchul Kim, and Kwang-Sup Soh. "Observation of the Primo Vessel Approaching the Axillary Lymph Node with the Fluorescent Dye, DiI." Evidence-Based Complementary and Alternative Medicine 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/287063.
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The primo vascular system (PVS) floating in lymph fluid has mostly been observed in large caliber ducts around the caudal vena cava and the thoracic duct of rabbits, rats, and mice. But the PVS has not been traced up to the lymph nodes. It has not been established whether the PVS leaves the lymph vessel through the lymph vessel wall or it enters the lymph nodes. Therefore, observing the PVS entering a lymph node, for example, the axillary node, is desirable. In the current work, we traced the PVS approaching up to the surface of axillary node of a rat. The method used for this study was based upon a method that was recently developed to detect the PVS in the lymph duct from the inguinal to the axillary nodes in the skin of a rat by injecting Alcian blue into the inguinal node. However, the Alcian blue blurred near the lymph nodes and tracing the PVS up to the lymph nodes has not been possible. The current method clearly showed the PVS approaching the axillary node.
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Boran, Nurettin, Fulya Kayikçioğrlu, Gokhan Tulunay, and M. Faruk Kose. "Scalene Lymph Node Dissection in Locally Advanced Cervical Carcinoma: Is it Reasonable or Unnecessary?" Tumori Journal 89, no. 2 (March 2003): 173–75. http://dx.doi.org/10.1177/030089160308900213.
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Aims and background The aim of this study was to evaluate the routine use of scalene lymph node dissection to determine the degree of disease spread in women with stage IIB-IVA cervical cancer treated at our hospital. Methods and study design Patients with locally advanced cervical carcinoma underwent para-aortic lymph node dissection via the extraperitoneal approach. Patients with clinical evidence of scalene or supraclavicular node metastasis were excluded. If their paraaortic nodes were tumor-positive, patients underwent scalene lymph node dissection. Results Twenty-eight scalene lymph node samplings were performed. Three patients had microscopically positive scalene lymph nodes (10.7%). In one patient the thoracic duct was injured. Conclusion Patients with cervical carcinoma whose only extrapelvic site of metastases is the para-aortic lymph nodes may be eligible for scalene lymph node dissection as part of their pretreatment assessment, especially if extended field radiation is considered.
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Dewar, D. J., B. Newell, M. A. Green, A. P. Topping, B. W. E. M. Powell, and M. G. Cook. "The Microanatomic Location of Metastatic Melanoma in Sentinel Lymph Nodes Predicts Nonsentinel Lymph Node Involvement." Journal of Clinical Oncology 22, no. 16 (August 15, 2004): 3345–49. http://dx.doi.org/10.1200/jco.2004.12.177.
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Purpose Sentinel node biopsy is now widely accepted as the most accurate prognostic indicator in melanoma, and is important in guiding management of patients with clinical stage I or II disease. Patients with a positive sentinel node have conventionally undergone completion lymphadenectomy (CLND) of the involved basin, but only 20% have involvement beyond the sentinel node, suggesting that CLND may be unnecessary for the other 80% of patients. This study seeks to identify criteria that might be used to be more restrictive in selecting those who should undergo CLND. Methods A total of 146 patients were identified who had had a positive sentinel node biopsy for malignant melanoma. Their sentinel nodes and lymphadenectomy specimens were re-evaluated pathologically. The metastatic melanoma in each sentinel node was assessed according to its microanatomic location within the node (subcapsular, combined subcapsular and parenchymal, parenchymal, multifocal, or extensive), and this was correlated with the presence of involved nonsentinel nodes in the CLND. The depth of the metastases from the sentinel node capsule was also recorded. Results The metastatic deposits in the sentinel node were subcapsular in 26.0% of patients. None of these patients had any nonsentinel nodes involved on CLND. In the patients whose sentinel node metastases had a different microanatomic location, the rate of nonsentinel node involvement was 22.2% overall. Conclusion The microanatomic location of metastases within sentinel nodes predicts nonsentinel lymph node involvement. In patients with only subcapsular deposits in the sentinel node, it is possible that CLND could safely be avoided.
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Gil’metdinov, A. F., and V. P. Potanin. "Significance of ipsilateral lobar lymph node dissection in the surgical treatment of non-small cell lung cancer with regional lymph node involvement." Kazan medical journal 98, no. 1 (February 15, 2017): 137–40. http://dx.doi.org/10.17750/kmj2017-137.
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Aim. Analysis of significance of ipsilateral lobar lymph node dissection in the surgical treatment of non-small cell lung cancer with regional lymph node involvement.Methods. We have analyzed medical records of inpatients and outpatients observed in Republican Clinical Oncology Dispensary of Tatarstan Ministry of Healthcare and operated in 2000-2009. Patients were divided into the groups according to the stage (IB, IIB, IIIA), clinical and anatomic form (peripheral or central cancer), volume of surgery (lobectomy and pulmonectomy) and degree of primary tumor spread and lymph node involvement according to TxNx (T2N0, T2N1, T3N0, T2N2). Total of 803 patients were included. Five-year survival rate in each group was counted by the method of Kaplan-Meier based on volume of surgery (lobectomy and pulmonectomy) and lymph node status (N1, N2).Results. In peripheral cancer with regional lymph nodes status N1-2 pulmonectomy with removal of ipsilateral lobar lymph nodes is associated with low survival. In central cancer regional lymph node status change from N0 to N1 does not influence survival after lobectomy/pulmonectomy indicating the positive effect of removal of ipsilateral lobar lymph nodes on survival in this group of patients. In central cancer with N2 survival after pulmonectomy decreases by 2 times indicating no influence of removal of ipsilateral lobar lymph nodes on survival in this group of patients.Conclusion. In peripheral cancer with morphologic confirmation of regional lymph node involvement N1-2, as well as in central cancer with morphologic confirmation of regional lymph node involvement N2, ipsilateral lobar lymph node dissection is irrational; in all other cases (central cancer N0-1 or peripheral cancer N0) ipsilateral lobar lymph node dissection is rational.
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Pargaonkar, Anjali S., Robert S. Beissner, Samuel Snyder, and V. O. Speights. "Evaluation of Immunohistochemistry and Multiple-Level Sectioning in Sentinel Lymph Nodes From Patients With Breast Cancer." Archives of Pathology & Laboratory Medicine 127, no. 6 (June 1, 2003): 701–5. http://dx.doi.org/10.5858/2003-127-701-eoiams.
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Abstract Context.—Previous investigations on sentinel lymph node biopsies have demonstrated their importance in nodal staging of patients with breast cancer. However, sentinel node biopsy in breast cancer is currently a controversial procedure and continues to provoke debate. Objectives.—We designed our study to determine the usefulness of a standard protocol for evaluating sentinel lymph node metastases and to assess the value of sentinel node biopsy as the only procedure in nodal staging in breast cancer patients. Materials and Methods.—A retrospective analysis of 84 breast cancer patients with sentinel node biopsies, who also underwent axillary dissection, was conducted using a standard protocol (3 levels of immunohistochemical stains for keratin and 2 levels of hematoxylin-eosin (HE) stains on the first 3 negative lymph nodes). Results.—Hematoxylin-eosin staining identified 20 patients (23.8%) with sentinel node metastases. The remaining 64 negative patients (76.1%) were tumor free on sentinel lymph nodes at level 1 HE. Additional immunohistochemical stains for keratin and HE stains on specimens from these 64 patients showed an additional 5 patients (7.8%) to be positive for lymph node micrometastases (<2 mm). The total percentage of cases with sentinel lymph node metastases detected by HE staining and immunohistochemistry was 29.7%. Of the remaining 59 cases that were negative on HE and immunohistochemistry, axillary dissection revealed 3 cases that had metastases in the axillary lymph nodes. The false-negative rate was 10.7%. The concordance rate between sentinel lymph nodes and axillary lymph nodes was 96.4%. The sensitivity was 89% and specificity was 100%. Conclusion.—Immunohistochemistry and multiple-level sectioning increased detection of metastases by 7.8% in sentinel lymph nodes. Caution should be used in accepting sentinel node biopsy alone as the only procedure for staging due to a high false-negative rate (10.7%). A predictive value of 96.4% confirms that sentinel lymph node biopsy is most likely to contain metastatic carcinoma. Sentinel lymph node examination with the protocol we describe, combined with axillary dissection, increased the yield of metastatic disease by identifying 8 additional cases of nodal metastatic disease (an increase of 28%), as compared to standard axillary nodal dissection and single-section sentinel lymph node examination alone.
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Deng, Jingyu, Han Liang, Dan Sun, Rupeng Zhang, Hongjie Zhan, and Xiaona Wang. "Prognosis of Gastric Cancer Patients with Node-Negative Metastasis following Curative Resection: Outcomes of the Survival and Recurrence." Canadian Journal of Gastroenterology 22, no. 10 (2008): 835–39. http://dx.doi.org/10.1155/2008/761821.
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BACKGROUND: The purpose of the present study was to provide valuable prognostic information on lymph node-negative gastric cancer patients following curative resection.METHODS: Data from 112 lymph node-negative gastric cancer patients who underwent curative resection were reviewed to identify the independent factors of overall survival and recurrence.RESULTS: The five-year survival rate of lymph node-negative gastric cancer patients was 85.7%, and recurrence was identified in 25 patients after curative surgery. The five-year survival rate of lymph node-negative gastric cancer patients was higher than that of lymph node-positive gastric cancer patients (P<0.001). Recurrence in lymph node-negative gastric cancer patients was less than that of lymph node-positive gastric cancer patients (P=0.001). The median survival after recurrence of lymph node-negative gastric cancer patients was longer than that of lymph node-positive gastric cancer patients (P=0.021). Using multivariate analyses, the following results were determined for lymph node-negative gastric cancer patients: sex, operative type and the presence of serosal involvement were independent factors of overall survival; and lymphadenectomy, number of dissected nodes and the presence of serosal involvement were independent factors of recurrence.CONCLUSIONS: The prognosis of lymph node-negative gastric cancer patients was better than that of lymph node-positive gastric cancer patients. Male sex, subtotal gastrectomy and nonserosal involvement should be considered to be the favourable predictors of postoperative long-term survival of lymph node-negative gastric cancer patients. Conversely, limited lymphadenectomy, few dissected nodes and serosal involvement should be considered to be risk factors of postoperative recurrence of lymph node-negative gastric cancer patients.
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Pagliarulo, Vincenzo, Debra Hawes, Frank H. Brands, Susan Groshen, Jie Cai, John P. Stein, Gary Lieskovsky, Donald G. Skinner, and Richard J. Cote. "Detection of Occult Lymph Node Metastases in Locally Advanced Node-Negative Prostate Cancer." Journal of Clinical Oncology 24, no. 18 (June 20, 2006): 2735–42. http://dx.doi.org/10.1200/jco.2005.05.4767.
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Purpose The purpose of this study was to determine the incidence and clinical significance of occult metastases in the lymph nodes of patients with prostate cancer originally considered node negative by routine histologic evaluation. Methods Two hundred seventy four patients with pT3 prostate carcinoma treated by radical prostatectomy and bilateral lymph node dissection were included in this study. One hundred eighty patients were staged node negative (N0), while 94 patients were lymph node positive (N+), based on routine histologic evaluation. All lymph nodes from the 180 N0 patients were evaluated for occult metastases by immunohistochemistry using antibodies to cytokeratins and, if positive, prostate-specific antigen. Recurrence and overall survival were compared among patients with occult tumor cells (OLN+), with patients whose lymph nodes remained negative (OLN−), and with the 94 N+ patients. Results A total of 3,914 lymph nodes were evaluated from 180 N0 patients (average, 21.7 lymph nodes per patient). Occult tumor cells were found in 24 of 180 patients (13.3%). The presence of OLN+ was significantly associated with increased recurrence and decreased survival compared with OLN− patients (P < .001 and P = .019, respectively; relative risk of recurrence, 2.27; relative risk of death 2.07, respectively). The presence of occult lymph node metastases was an independent predictor of recurrence and death in a multivariable analysis. The outcome for patients with OLN+ disease was similar to that for patients with N+ disease. Conclusion The detection of occult lymph node metastases in patients with pT3N0 prostate cancer identifies those with significantly increased risk of prostate cancer recurrence and death.
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Wang, Jundong, Xiaoli Lu, Xuan Zheng, Congyan Xia, and Ping Li. "Clinical Value of Preoperative Ultrasound Signs in Evaluating Axillary Lymph Node Status in Triple-Negative Breast Cancer." Journal of Oncology 2022 (May 14, 2022): 1–7. http://dx.doi.org/10.1155/2022/2590647.
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Purpose. To explore the clinical value of preoperative ultrasound signs in evaluating axillary lymph node status in triple-negative breast cancer (TNBC). Methods. A retrospective study was conducted on 162 patients with TNBC who were admitted to our hospital from January 2017 to June 2021. A total of 62 patients with axillary lymph node metastasis and 100 patients with normal axillary lymph nodes were included. Univariate and logistic regression was used to analyze the correlation between clinicopathological parameters, ultrasound features, and axillary lymph node metastasis between these two groups. The receiver operating characteristic (ROC) curve of each index was drawn to predict positive axillary lymph node. Results. The lymph node positive rate was higher in patients with tumor size ( 2 mm < T ≤ 5 mm ) and tumor stage III, and the difference between these two groups was statistically significant ( P < 0.05 ). The patients with cortical thickness ≥ 3 , blood flow grades II-III, aspect ratio L / S ≥ 2 , and RI ≥ 0.7 had higher lymph node positive rate, and the difference between these two groups was statistically significant ( P < 0.05 ). Other index shows no correlation with ancillary lymph node positive rate, or the correlation was not statistically significant ( P > 0.05 ). Further regression analysis indicated that the blood flow grade and L/S of axillary lymph nodes were independent influencing factors of axillary lymph node metastasis in TNBC patients ( P < 0.05 ). Relevant receiver operating characteristic (ROC) curves were constructed, and the AUC of axillary lymph node blood flow grade and L/S for predicting axillary lymph node status was 0.6329 and 0.6498, respectively. The AUC for the joint prediction of the two indicators is 0.6898. Conclusion. Ultrasound sign combined with clinicopathological characteristics can predict the axillary lymph nodes metastasis in TNBC, which could guide clinical decision of axillary lymph node surgery.
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Dai, Wei, Yuanqiang Zhang, Xueming Li, Lin Peng, and Yongtao Han. "PS02.203: CHARACTERISTICS AND RISK FACTORS OF LYMPH NODE METASTASIS IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA PATIENTS WITH PREOPERATIVE COMPUTED TOMOGRAPHY-NEGATIVE LYMPH NODES." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 179–80. http://dx.doi.org/10.1093/dote/doy089.ps02.203.
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Abstract Background Characteristics and risk factors of lymph node metastasis (LNM) in esophageal squamous cell carcinoma (ESCC) patients with preoperative computed tomography (CT)-negative lymph nodes are not well elucidated. This study aimed to identify the characteristics and risk factors of LNM in ESCC patients with preoperative CT-negative lymph nodes. Methods We conducted a retrospective analysis of consecutive ESCC patients who had preoperative CT-negative lymph nodes and received esophagectomies between August 2013 and July 2016. Lymph node with a short-axis diameter ≦10 mm on preoperative CT image was considered as CT-negative lymph node. Eligible patients included those: aged 18∼80, without neoadjuvant therapy, without other malignant tumor history, without distant metastasis, without multiple esophageal lesions, tumor locating in the thoracic esophagus, receiving McKeown esophagectomy, undergoing R0 resection, having number of lymph nodes resection≧15, pathological staging as T1a-4aN0–3. Univariate and multivariate logistic regression analyses were used to identify risk factors of LNM. Results Among 243 ESCC patients identified, 137 had LNM (56.4%). The median number of lymph nodes dissected and LNM were 24 (range 15–79) and 2 (range 1–14), respectively. The rates of LNM of the upper, middle and lower thoracic ESCC were 50.0%, 59.3% and 55.1%, respectively. The rates of LNM with the maximal short-axis diameter of lymph node on preoperative CT of ≦5 mm, 6 mm, 7 mm, 8 mm, 9 mm and 10 mm were 57.4%, 42.9%, 47.4%, 31.8%, 73.9% and 70.8%, respectively (P = 0.034). Univariate analysis showed that age (P = 0.041), maximal short-axis diameter of lymph node on CT (P = 0.034), cervical lymph node dissection (P = 0.031), lymphovascular invasion (P < 0.001) and perineural invasion (P = 0.017) were associated with LNM. Multivariate analysis revealed that cervical lymph node dissection (P = 0.018), lymphovascular invasion (P = 0.007) and perineural invasion (P = 0.025) were independent risk factors of LNM. Conclusion Our study showed that the rates of LNM were also high in ESCC patients with preoperative CT-negative lymph nodes. Standard lymph node dissection is necessary for these patients. Cervical lymph node dissection, lymphovascular invasion and perineural invasion are independent risk factors of LNM in ESCC patients with preoperative CT-negative lymph nodes. Disclosure All authors have declared no conflicts of interest.
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Hussain, T., and PJ Kneeshaw. "Axillary lymph node clearance in patients with positive sentinel lymph node biopsy." Annals of The Royal College of Surgeons of England 96, no. 3 (April 2014): 199–201. http://dx.doi.org/10.1308/003588414x13814021678592.
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Introduction The use of adjuvant radiotherapy is standard practice following breast conserving surgery and mastectomy in selected patients. Prospective clinical trials are currently being designed to assess the effect of omitting axillary lymph node clearance (ALNC) in selected patients. The aim of this study was to identify the percentage of patients understaged and not considered for postmastectomy radiotherapy (PMRT) and/or supraclavicular fossa radiotherapy (SCFRT) with positive sentinel lymph node (SLN) macrometastasis if the proposed prospective trial inclusion/exclusion protocols are followed. Methods A total of 38 women who were found negative for axillary metastases preoperatively but positive at SLN biopsy and who had ALNC were analysed. PMRT or SCFRT was offered to patients if ≥4 positive lymph nodes (including sentinel nodes) were positive for macrometastasis and/or a tumour size of ≥5cm was detected. Fisher’s exact test was used to determine the statistical significance of omitting ALNC. Results The mean age of the 38 patients was 55 years. A fifth (21.1%) of patients had T1, 76.3% had T2 and 2.6% had T3 disease. The percentage of positive SLNs was 52.6% (1 node), 34.2% (2 nodes) and 13.1% (3 nodes). The number of positive nodes at clearance was 0–3. If the inclusion criteria for trials that consider omitting ALNC are followed (eg POSNOC trial), 23.7% of patients (p=0.0001) with ≥4 positive nodes (including SLNs) would not be offered SCFRT and PMRT. Similarly, if multicentric disease were to be excluded from the trial criteria, the proportion of undertreated patients would reduce by 15.7%. Conclusions Our study has shown a significant risk of missing patients for PMRT or SCFRT if no ALNC is offered in the presence of SLN macrometastasis. Tumour multicentricity is an important factor in predicting high axillary nodal involvement. Consequently, exclusion of T2 tumours with multicentric involvement in trials considering omitting ALNC may be more appropriate.
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Göçmen, Ahmet, Fatih Şanlıkan, and Muhittin Eftal Avcı. "Robotic-Assisted Dissection of Bulky Lymph Nodes in Cervical Cancer." Case Reports in Obstetrics and Gynecology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/965698.
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The resection of bulky lymph node metastases, which may provide a therapeutic benefit, has been proposed in several studies based on laparotomy and laparoscopy. There is no published study in the literature examining the resection of bulky lymph node metastases using a robotic technique. In this report, we presented a patient with cervical cancer who underwent robotic-assisted dissection of bulky lymph nodes. The robotic-assisted operation time was 255 minutes, and the mean console time was 215 minutes. The estimated blood loss was 70 mL. The number of lymph nodes retrieved was 28, and the number of the dissected paraaortic lymph nodes was 13. The number of the lymph node metastases was eight. The bulky lymph nodes which are difficult to be eradicated with standard radiation therapy can be resected with robotic-assisted surgery and successful resection of the lymph nodes can improve the treatment strategy. This minimal invasive technique is safe and feasible for bulky lymph node dissection.
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Chen, Jian, Deguang Zhang, Liang Fang, Gaofei He, and Li Gao. "Lymph node metastasis in the space between the right carotid artery and jugular vein in papillary thyroid carcinoma." Journal of International Medical Research 48, no. 4 (April 2020): 030006052092003. http://dx.doi.org/10.1177/0300060520920036.
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Background The oblique brachiocephalic trunk and right common carotid artery constitute the right carotid sheath space (RCSS). The aim of this study was to detect the clinicopathologic factors associated with RCSS lymph node metastasis. Methods In total, 232 papillary thyroid carcinoma (PTC) patients with preoperative contrast-enhanced computed tomography scans were analyzed for associations between RCSS lymph node metastasis and clinicopathological factors. Results Among the 232 cases, 18 (7.76%) had suspicious RCSS lymph nodes, which was correlated with the presence of >5 metastatic lymph nodes, a larger thoracic inlet, and primary tumor size >2.15 cm. All pathologically confirmed metastatic lymph nodes were >1 cm in diameter. Conclusions The concept of “RCSS lymph node metastasis” was first introduced by this study. For PTC patients, a larger thoracic inlet, increased number of metastatic lymph nodes, and larger primary tumor size were related to RCSS lymph nodes, and more attention should be paid to patients who have lymph nodes >1 cm. A future prospective study will be designed to identify the potential risk factors for RCSS lymph node metastasis.
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Vicus, Danielle, and Allan Covens. "Role of Sentinel Lymph Node Biopsy in Cervical Cancer: Pro." International Journal of Gynecologic Cancer 20, Suppl 2 (September 2010): S34—S36. http://dx.doi.org/10.1111/igc.0b013e3181f60d60.
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Sentinel lymph node biopsy in cervical cancer is used to reduce the morbidity of a full lymph node dissection while improving the pickup rate of metastatic lymph nodes. The higher detection rate achieved can be explained by the following: the identification of the sentinel lymph node in an aberrant location which would not be routinely included in a systematic pelvic lymph node dissection, the sentinel lymph node is completely excised, and the routine use of ultrastaging. The higher detection rate achieved through sentinel lymph node biopsy can identify additional patients who could potentially benefit from adjuvant therapy therefore, in our view the gold standard of lymph node assessment in early stage cervical cancer has shifted and sentinel lymph node biopsy has taken the place of a complete lymphadenectomy.
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Ramsay, Stuart C., Nathan Cassidy, and Sally Meade. "Clinically Node-Negative Breast Cancer, Internal Mammary Lymph Nodes, and Sentinel Lymph Node Biopsy." Clinical Nuclear Medicine 33, no. 6 (June 2008): 391–93. http://dx.doi.org/10.1097/rlu.0b013e318170d569.
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Hadamitzky, Catarina, Hanes Perić, Sebastian J. Theobald, Klaus Friedrich Gratz, Hendrik Spohr, Reinhard Pabst, and Peter M. Vogt. "Effect of cryopreservation on lymph node fragment regeneration after autologous transplantation in the minipig model." Innovative Surgical Sciences 3, no. 2 (April 20, 2018): 139–46. http://dx.doi.org/10.1515/iss-2018-0003.
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AbstractIntroduction:Lymphoedema is a worldwide pandemic causing swelling of tissues due to dysfunctional transport of lymph fluid. Present management concepts are based in conservative palliation of symptoms through manual lymphatic drainage, use of compression garments, manual lymph drainage, exercise, and skin care. Nevertheless, some curative options as autologous lymph node transplantation were shown to reduce lymphoedema in selected cases. Lately, some concern has arisen due to reports of donor site morbidity. A possible solution could be the development of artificial lymph node scaffolds as niches of lymphatic regeneration. Engineering these scaffolds has included cryopreservation of lymph node stroma. However, the effects of cryopreservation on the regeneration capacities of these organs were unknown.Materials and methods:Here, we used the minipig animal model to assess lymphatic regeneration processes after cryopreservation of autologous lymph nodes. Superficial inguinal lymph nodes were excised and conserved at −80°C for 1 month. Thereafter, lymph node fragments were transplanted in the subcutaneous tissue.Results:Regeneration of the lymph nodes was assessed five months after transplantation. We show that lymph node fragment regeneration takes place in spite of former cryopreservation. Transplanted fragments presented typical histological appearance. Their draining capacity was documented by macroscopic transport of Berlin Blue dye as well as through SPECT-CT hybrid imaging.Discussion:In conclusion, our results suggest that processes of cryopreservation can be used in the creation of artificial lymph node scaffolds without major impairment of lymph node fragments regeneration.
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Yoshizawa, Tadashi, Keinosuke Ishido, Kensuke Saito, Toshihiro Haga, Hiroko Seino, Yunyan Wu, Satoko Morohashi, Kenichi Hakamada, and Hiroshi Kijima. "Prognostic Impact of Extracapsular Lymph Node Invasion and Myofibroblastic Activity in Extrahepatic Bile Duct Cancer." Clinical Medicine Insights: Pathology 10 (January 1, 2017): 117955571772965. http://dx.doi.org/10.1177/1179555717729652.
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Extrahepatic bile duct carcinoma is a potentially malignant gastrointestinal lesion. Cancer cells spread via the lymphatic system to regional lymph nodes and help in tumor progression. However, there are no reports on the prognostic impact of extracapsular lymph node invasion and myofibroblastic activity in this cancer. Hence, we classified the histopathologic patterns of lymph nodes into 2 patterns: extracapsular lymph node invasion or not. Based on this, we investigated 32 cases of extrahepatic bile duct cancer with lymph node metastasis and classified 21 cases as positive and 11 cases as negative. The extracapsular lymph node invasion cases were associated with poor disease-free survival and overall survival. The myofibroblast density of the metastatic foci was significantly higher in the extracapsular lymph node invasion cases. This is the first study to demonstrate that extracapsular lymph node invasion cases were associated with poor prognosis and that the myofibroblast distribution contributed to malignancy.
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Luchey, Adam, Patrick Espiritu, Jared Gopman, Gautum Agarwal, Julio M. Pow-Sang, Wade Jeffers Sexton, and Philippe E. Spiess. "Inguinal lymph node dissection for penile cancer: Predictors of lymph node metastasis." Journal of Clinical Oncology 32, no. 4_suppl (February 1, 2014): 386. http://dx.doi.org/10.1200/jco.2014.32.4_suppl.386.
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386 Background: Inguinal lymph node dissection (ILND) for lymph node metastasis (LNM) of squamous cell carcinoma of the penis (SCCP) can be a curative surgical treatment. Having the potential to identify clinical and pathological factors that predict LNM is important because of the poor prognosis this diagnosis carries. Methods: A retrospective review of 51 patients that underwent inguinal plus pelvic lymph node dissection from 1999 to 2012 was preformed. Age, race, body mass index (BMI), significant lymphadenopathy on preoperative imaging (nodes > 1 cm), palpable lymphadenopathy, and pathologic depth of invasion and diameter of the primary penile tumor along with associated lymphovascular invasion (LVI) were recorded and analyzed as potential predictors of LNM. Results: Median patient age was 65 and the median BMI was 29.3. Thirty-nine patients (76.5%) were white, 3 (5.9%) African American, and 9 (17.6%) were Hispanic. Median primary penile tumor diameter was 3.2 cm with 7, 29, and 15 patients having well, moderate, and poorly differentiated tumors. Pre-operatively, 32 patients (62.7%) had palpable lymphadenopathy on physical exam and 26 (51.0%) had significant lymphadenopathy on imaging (93% CT, 7% MRI), with 24 (47.1%) having both findings. Thirty-one patients (60.8%) who underwent ILND had pathological LNM. On univariate analysis, palpable nodes (p < 0.001), nodes on imaging (p <0.001), having both palpable nodes and nodes on imaging (p < 0.001), age (p = 0.02), and LVI (p = 0.04), were significantly associated with LMN. On multivariate analysis, having nodes on imaging (p = 0.001) and age < 65 years (p = 0.049) were significant for predicting LNM. Conclusions: In evaluation of patients with T1-T3 penile cancer, multiple factors were predictive of LNM in our series: palpable and radiographic nodes, younger than age 65 and LVI. Inguinal adenopathy defined as more than 1 cm appears to better predict occult nodal metastasis, however, this must be weighed in terms of the additional cost and clinical yield provided by widespread adoption of pelvic (CT or MRI) imaging in all patients with aggressive primary penile tumor phenotypes.
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Oliveira, Andrea Fernandes de, Ivan Dunshee de Abranches Oliveira Santos, Thaís Cardoso de Mello Tucunduva, Luciana Garbelini Sanches, Renato Santos Oliveira Filho, Mílvia Maria Simões e. Silva Enokihara, and Lydia Masako Ferreira. "Sentinel lymph node biopsy in cutaneous melanoma." Acta Cirurgica Brasileira 22, no. 5 (October 2007): 332–36. http://dx.doi.org/10.1590/s0102-86502007000500002.
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PURPOSE: To assess the importance of sentinel lymph node biopsy in patients with cutaneous melanoma. METHODS: Ninety consecutive non-randomized patients with stages I and II melanoma who underwent sentinel lymph node biopsy were followed up prospectively for six years. RESULTS: Patients were followed up for a mean period of 30 months. Their mean age was 53.3 years, ranging from 12 to 83 years. Thirty patients were male (37.5%) and 50, female (62.5%). Sentinel lymph node was positive in 32.5% and negative in 67.5%. It was found that the thicker the tumor, the greater the incidence of positive sentinel lymph nodes. In the group of patients with positive sentinel lymph nodes, recurrence occurred in 43.5%, but in those with negative sentinel lymph nodes, in only 7%, what points out to the association of tumor recurrence and positive sentinel lymph nodes. There were no major postoperative complications. CONCLUSION: Sentinel lymph node biopsy was demonstrated to be a safe method for selecting patients who need therapeutic lymphadenectomy.
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Zhang, Jianliang, Guangwei Jia, Yang Su, Zhongji Zhang, Hui Xiong, Qiu Xu, and Shan Meng. "Prediction of Cervical Lymph Nodes Metastasis in Papillary Thyroid Carcinoma (PTC) Using Nodal Staging Score (NSS)." Journal of Oncology 2022 (October 15, 2022): 1–7. http://dx.doi.org/10.1155/2022/9351911.
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Background. Cervical lymph node metastasis is commonly seen in papillary thyroid carcinoma. Surgery is the preferred treatment for PTC with cervical lymph node metastasis. There is no alternate ultrasound, neck CT, and thyroglobulin (Tg) methods to assess the occult lymph node metastasis. For moderate-and high-risk PTC, the number of lymph nodes to be dissected should be increased to remove the occult lymph node metastasis. Objective. This study was designed to develop a nodal staging score model to predict the likelihood of lymph node metastasis in papillary thyroid carcinoma (PTC), and further guide the treatments. Material and Methods. Data were collected from the SEER database. Patients with PTC from 2000 to 2005 were selected. The beta-binomial model was adopted to establish a nodal staging score (NSS)-based model. The NSS-based model was built according to gender, age, extrathyroidal invasion, tumor multifocality, tumor size, and T stage of the patients. A total of 12,431 PTC patients were included in our study. Various types of lymph nodes were examined based on various categories (incidence, risk assessment) to evaluate the results. Results. 5,959 (47.9%) patients in the study were positive and 6,472 (52.1%) were confirmed negative for lymph node metastasis. The corrected incidence of lymph node metastasis was higher than that of direct calculation, regardless of the factors that affected lymph node metastasis. There were significant differences in the OS of PTC patients among the four groups and T stage ( p is less than 0.05), indicating that cervical lymph node metastasis would have an impact on the prognosis of patients. Conclusion. In conclusion, an NSS-based model base on a variety of clinicopathological factors can be used to predict lymph node metastasis. It is important to evaluate the risk of occult lymph node metastasis in the treatment of PTC.. Since, this statistical model can describe the risk of occult lymph node metastasis in patients; therefore, it can be used as basis for decision-making related to the number of lymph nodes that can be dissected in operations.
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Liu, Lu, Xi Li, Yulin Hu, Jingyue Sun, Jielin Chen, Desheng Xiao, Wei Wu, and Bin Xie. "Lymph Node Cluster Dissection After Carbon Nanoparticles Injection Enhances the Retrieval Number in Colorectal Cancer." Journal of Biomedical Nanotechnology 18, no. 7 (July 1, 2022): 1885–96. http://dx.doi.org/10.1166/jbn.2022.3397.
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For colorectal cancer patients, NCCN recommended that at least 12 lymph nodes should be detected since the number and metastases status of lymph nodes played an important role in the treatment and prognostic. Carbon nanoparticles have been proved to be an efficient lymph node tracer. Faced with the clinical problem of insufficient lymph nodes in colorectal cancer, we proposed a lymph node cluster (D3, D2 and D1) dissection method combined with carbon nanoparticle injection. In our study, patients were divided into 2 groups (CNP and control). All lymph nodes of each patient were collected and made into hematoxylin-eosin sections to observe their size, staining appearance and metastasis status under the microscope. As a result, the total lymph nodes in CNP group were greatly higher than control group (51.45 vs. 29.62, P = 0.000), especially micro LNs and positive micro LNs. Compared with D2 and D1 stations, fewer lymph nodes were found in D3, and it was the same for cancer metastasis status. In CNP group, most lymph nodes got black for quick visualization. In conclusion, lymph node cluster dissection combined with carbon nanoparticles could enhance the number of lymph node retrieval.
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Sasor, Sarah, Sunil Tholpady, Michael Chu, and Julia Cook. "Omental Vascularized Lymph Node Flap: A Radiographic Analysis." Journal of Reconstructive Microsurgery 34, no. 07 (April 16, 2018): 472–77. http://dx.doi.org/10.1055/s-0038-1642637.
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Background Vascularized lymph node transfer is an increasingly popular option for the treatment of lymphedema. The omental donor site is advantageous for its copious soft tissue, well-defined collateral circulation, and large number of available nodes, without the risk of iatrogenic lymphedema. The purpose of this study is to define the anatomy of the omental flap in the context of vascularized lymph node harvest. Methods Consecutive abdominal computed tomography angiography (CTA) images performed at a single institution over a 1-year period were reviewed. Right gastroepiploic artery (RGEA) length, artery caliber, lymph node size, and lymph node location in relation to the artery were recorded. A two-tailed Z-test was used to compare means. A Gaussian Mixture Model confirmed by normalized entropy criterion was used to calculate three-dimensional lymph node cluster locations along the RGEA. Results In total, 156 CTA images met inclusion criteria. The RGEA caliber at its origin was significantly larger in males compared with females (p < 0.001). An average of 3.1 (1.7) lymph nodes were present per patient. There was no significant gender difference in the number of lymph nodes identified. Average lymph node size was significantly larger in males (4.9 [1.9] × 3.3 [0.6] mm in males vs. 4.5 [1.5] × 3.1 [0.5] mm in females; p < 0.001). Three distinct anatomical variations of the RGEA course were noted, each with a distinct lymph node clustering pattern. Total lymph node number and size did not differ among anatomical subgroups. Conclusion The omentum is a reliable lymph node donor site with consistent anatomy. This study serves as an aid in preoperative planning for vascularized lymph node transfer using the omental flap.
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A, Hemalatha, Udaya Kumara M, and Harendran Kumar M. L. "Fine needle Aspiration Cytology of Lymph Nodes: A Mirror in the Diagnosis of Spectrum of Lymph Node Lesions." JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES 01, no. 4 (December 15, 2011): 164–72. http://dx.doi.org/10.58739/jcbs/v01i4.6.
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Masood, S. "Micrometastasis in lymph node." Breast Cancer Online 9, no. 5 (March 29, 2006): 1–3. http://dx.doi.org/10.1017/s1470903105003342.
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Determining whether cancer has spread to the lymph nodes is important in predicting survival from breast cancer and determining what treatment a patient requires. The traditional method of detecting such metastases, complete axillary node dissection, can result in lymphedema and other quality-of-life damaging side effects. The new technique of sentinel lymph node biopsy (SLNB) offers a way to test for lymph node metastases without causing the side effects of traditional axillary node dissection. Intraoperative analysis of SLNB is becoming an effective tool in assessment of the presence or absence of metastatic tumor, and therefore influences the treatment offered to the patient. Because of this central diagnostic use, as it is a new procedure, further studies need to be conducted to fully assess its role in breast cancer treatment.
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Liu, Jun, Xiaolong Fu, Hongxuan Li, Yan Cheng, and Zhigang Li. "RA04.05: PREVALENCE OF LYMPH-NODE METASTASIS IN T1B ESOPHAGEAL SQUAMOUS CELL CANCER: IMPLICATIONS FOR ADDITIONAL RADIOTHERAPY DESIGN FOLLOWING ENDOSCOPIC SUBMUCOSAL DISSECTION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 26. http://dx.doi.org/10.1093/dote/doy089.ra04.05.
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Abstract Background Endoscopic submucosal dissection (ESD) can be used as a less invasive treatment option for early esophageal cancer. But how to prevent lymph node metastasis is essential in these patients. This study aimed to analyze prevalence of lymph nodes metastasis for T1b thoracic esophageal squamous cell carcinoma(TESCC) patients treated in Shanghai Chest Hospital(SCH) and to propose a clinical target volume (CTV) for additional radiotherapy Clinical Target Volume design following endoscopic submucosal dissection(ESD) in these patients. Methods From 2012 to 2017, consecutive patients with T1b TESCC patients who underwent complete resection in SCH were identified. The prevalence of lymph-node metastasis were assessed and evaluated whether these metastasis areas would be encompassed by our proposed CTV. We proposed lymph-node stations (JEOG) 101, 104, 105, 106, 107 for upper TESCC, lymph-node stations 106, 107, 108, 1, 2, 3, 7, 8, 9, 10 for middle TESCC, and lymph-node stations110, 112, 1, 2, 3, 7, 8, 9, 10 for lower TESCC. Results There were 240 patients (80.4% male) who met the inclusion criteria, with a mean age of 62 ± 7 years. Of the total, 27.1%(65/240) patients presented with lymph nodes metastasis. Single lymph-node and single station lymph-node metastasis among positive nodes patients were 63.1%(41/65) and 70.8%(46/65), respectively.Tumor length exceeding 20mm and poor tumor differentiation but not age, gender, tumor position and tumor thrombus were independently associated with the risk of nodal disease. Among positive nodes patients, 89.2% (58/65) lymph-node metastasis for T1b TESCC patients could be covered by proposed CTV. Conclusion Prevalence of lymph node metastasis is high in patients with T1b TESCC. It seemed additional radiotherapy after ESD for those patients with high risk factors is needed to prevent lymph node metastasis. Majority positive nodes area could be covered by our proposed CTV. However, the value of radiotherapy and the proposed CTV should be investigated in further prospective studies. Disclosure All authors have declared no conflicts of interest.
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Togami, Shinichi, Takashi Ushiwaka, Mika Fukuda, Mika Mizuno, Shintaro Yanazume, Masaki Kamio, and Hiroaki Kobayashi. "Comparison of radio-isotope method with 99m technetium and near-infrared fluorescent imaging with indocyanine green for sentinel lymph node detection in endometrial cancer." Japanese Journal of Clinical Oncology 52, no. 1 (October 29, 2021): 24–28. http://dx.doi.org/10.1093/jjco/hyab172.
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Abstract Background We aimed to compare the detection rate of pelvic sentinel lymph node between the radio-isotope with 99m technetium (99mTc)-labeled phytate and near-infrared fluorescent imaging with indocyanine green in patients with endometrial cancer. Methods This study included 122 patients who had undergone sentinel lymph node mapping using 99mTc and indocyanine green. In the radio-isotope method, sentinel lymph nodes were detected using uterine cervix 99mTc injections the day before surgery. Following injection, the number and locations of the sentinel lymph nodes were evaluated by lymphoscintigraphy. In addition, indocyanine green was injected into the cervix immediately before surgery. Results The overall pelvic sentinel lymph node detection rate (at least one pelvic sentinel lymph node detected) was not significantly different between 99mTc (95.9% [117/122]) and indocyanine green (94.3% [115/122]). Similarly, the bilateral sentinel lymph node detection rate was not significantly different between 99mTc (87.7% [107/122]) and indocyanine green (79.5% [97/122]). More than two sentinel lymph nodes per unilateral pelvic lymph node were found in 12.3% (15/122) and 27% (33/122) of cases with 99mTc and indocyanine green, respectively, in the right pelvic side, and 11.5% (14/122) and 32.8% (40/122) of cases with 99mTc and indocyanine green, respectively, in the left pelvic side. indocyanine green showed that there were significantly more than two sentinel lymph nodes in either the left or right pelvic sentinel lymph nodes (P < 0.0001). There was a significant difference in the mean number of total pelvic sentinel lymph nodes between 99mTc (2.2) and indocyanine green (2.5) (P = 0.028) methods. Conclusion Although indocyanine green is useful for sentinel lymph node identification, we believe it is better to use it in combination with 99mTc until the surgeon is accustomed to it.
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Cecchi, Roberto, Cataldo De Gaudio, Lauro Buralli, and Stefania Innocenti. "Lymphatic Mapping and Sentinel Lymph Node Biopsy in the Management of Primary Cutaneous Melanoma: Report of a Single-centre Experience." Tumori Journal 92, no. 2 (March 2006): 113–17. http://dx.doi.org/10.1177/030089160609200205.
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Aims and Background Lymphatic mapping and sentinel lymph node biopsy provide important prognostic data in patients with early stage melanoma and are crucial in guiding the management of the tumor. We report our experience with lymphatic mapping and sentinel lymph node biopsy in a group of patients with primary cutaneous melanoma and discuss recent concepts and controversies on its use. Patients and Methods A total of 111 patients with stage I-II AJCC primary cutaneous melanoma underwent lymphatic mapping and sentinel lymph node biopsy from December 1999 through December 2004 using a standardized technique of preoperative lymphoscintigraphy and biopsy guided by blue dye injection in addition to a hand-held gamma probe. After removal, sentinel lymph nodes were submitted to serial sectioning and permanent preparations for histological and immunohistochemical examination. Complete lymph node dissection was performed only in patients with tumor-positive sentinel lymph nodes. Results Sentinel lymph nodes were identified and removed in all patients (detection rate of 100%), and metastases were found in 17 cases (15.3%). The incidence of metastasis in sentinel lymph nodes was 2.1%, 15.9%, 35.2%, and 41.6% for melanomas < or 1.0, 1.01-2.0, 2.01-4.0, and > 4.0 mm in thickness, respectively. Complete lymph node dissection was performed in 15 of 17 patients with positive sentinel lymph nodes, and metastases in non-sentinel lymph nodes were detected in only 2 cases (11.7%). Recurrences were more frequently observed in patients with a positive than in those with negative sentinel lymph node (41.1% vs 5.3% at a median follow-up of 31.5 months, P<0.001). The false-negative rate was 2.1%. Conclusions Our study confirms that lymphatic mapping and sentinel lymph node biopsy allow accurate staging and yield relevant prognostic information in patients with early stage melanoma.
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Emelyanov, Alexander, Krivorotko Petr, Roman Pesotskiy, Alexander Bessonov, Viktor Gorelov, and Vladimir Semiglazov. "Targeted axillary lymph node dissection in breast cancer patients using I-125 microseeds for prostate cancer brachytherapy." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e12601-e12601. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e12601.
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e12601 Background: To date, targeted axillary lymph node dissection is one of the possible methods of de-escalation of surgical aggression on the areas of regional lymph flow in breast cancer patients with confirmed metastases in the axillary lymph nodes prior to the neoadjuvant chemotherapy. There are no specialized microseeds for targeted axillary dissection. The purpose of our study was to determine the possibility of using I-125 microseed for prostate cancer brachytherapy for targeted axillary dissection. Methods: A prospective study of patients with biopsy-confirmed nodal axillary metastases with a I-125 microseed placed in the node was performed. I-125 microseed for prostate cancer brachytherapy was used to mark the axillary lymph node. After neoadjuvant therapy, patients underwent targeted axillary lymph node dissection in combination with SLNB with pathomorphological examination of marked lymph node and total axillary lymph node dissection with pathomorphological examination of over lymph nodes for FNR evaluation. Results: 45 breast cancer patients stage cT1-3N1M0 were enrolled in the study. The frequency of reaching ypN0 was 58%. Residual disease identified in 19 patients. The clipped node revealed metastases in 18 patients, resulting in an FNR of 5.26% (95% CI, to 20.6) for the clipped node. CIs for FNR were calculated using exact (Clopper-Pearson) confidence limits for the binomial proportion. Conclusions: Marking the biopsy-confirmed lymph node using a I-125 microseed prior neoadjuvant chemotherapy and performing targeted axillary lymph node dissection in combination with SLNB is a safe method for diagnosing axillary lymph nodes and allows you to abandon routine ALD for ypN0 patients. Advantages of I-125 microseed for prostate cancer brachytherapy: fixation in the lymph node without migration, the ability to use a standard gamma-probe to locate the microseed during the operation, these microseeds are registered for the treatment of cancer patients.
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Tanaka, Kentaro, Hiroki Mori, Mutsumi Okazaki, Aya Nishizawa, and Hiroo Yokozeki. "Long-Term Treatment Outcome after Only Popliteal Lymph Node Dissection for Nodal Metastasis in Malignant Melanoma of the Heel: The Only “Interval Node” Dissection Can Be an Adequate Surgical Treatment." Case Reports in Oncological Medicine 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/259326.
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We present a patient with malignant melanoma on his heel. Wide local excision was performed, along with sentinel lymph node biopsy of the inguinal and popliteal lesions. The primary site was clear of tumor at all margins; the inguinal nodes were negative, but the popliteal node was positive for metastatic melanoma. Only radical popliteal lymph node dissection was performed. The patient went on to receive adjuvant chemoimmunotherapy. There was no recurrence or complication until the long-term followup. Popliteal drainage from below the knee is uncommon, and the rate of popliteal-positive and inguinal-negative cases is estimated to be less than 1% of all melanomas. There is no established evidence about how to treat lymph nodes in these cases. Because we considered popliteal nodes as a regional, not interval, lymph node basin, only popliteal lymph node dissection was performed, and good postoperative course was achieved. The first site of drainage is the sentinel node, and the popliteal node can be a sentinel node. The inguinal node is not a sentinel node in all lower extremity melanomas. This case illustrates the importance of individual detailed investigation of lymphatic drainage patterns from foot to inguinal and popliteal nodes.
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Gupta, Seema, Madhuri Grover, and Vasundhara Saxena. "RECENT ADVANCEMENT ON ISOLATION, ACTIVATION AND CRYOPRESERVATION OF LYMPH NODE CELLS IN MICE." INTERNATIONAL JOURNAL OF PHARMACEUTICAL EDUCATION AND RESEARCH (IJPER) 3, no. 01 (May 28, 2021): 05–09. http://dx.doi.org/10.37021/ijper.v3i1.2.
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ABSTRACT
Lymph nodes are found within the body has B, T and other immune cells and help to filter and trap foreign particles. Like any other primary culture lymph node culture would retain many of differentiated characteristics of cells in vivo thus they have potential for acting as alternative method to mammalian model.
For setting up primary lymph node culture in mice different types of lymph nodes were collected from mice followed with isolation, activation and cryopreservation of cells from lymph node. The present review emphasize on various procedures used for isolation, activation and cryopreservation of lymph node cells. Isolation of cells was performed by collagenase digestion, teasing apart of lymph node using dissecting needle or lymph nodes were disrupted between two frosted slides. Concanavalin A have been widely used to stimulate mice lymph node cells. Low dose of Con A have stimulatory effect on T cells but high dose have inhibitory action and caused suppression of proliferation of T cell. Balb/c mice and C57Bl/6 mice were used for different dose of Con A. The addition of cryoprotective agents, e.g.dimethylsulphoxide and careful control of cooling rates affords protection from cell damage during freezing.
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Gantsev, S. K., M. A. Tatunov, K. S. Gantsev, S. R. Kzyrgalin, and R. S. Mukhamedyarov. "MICROSURGICAL METHODS OF EX VIVO EXAMINATION OF THE LYMPHATIC SYSTEM IN BREAST CANCER PATIENTS." Siberian journal of oncology 18, no. 3 (June 30, 2019): 71–77. http://dx.doi.org/10.21294/1814-4861-2019-18-3-71-77.
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The purpose of the study was ex vivo examination of lymph node perfusion in patients with metastatic breast cancer.Material and Methods. Lymph nodes affected with metastatic breast cancer were examined. These nodes were subsequently subjected to microsurgical dissection with the isolation of the capsule, lymphatic vessels, parenchyma and stroma. All manipulations were performed after preliminary lymph node dissection using an axillary node sample, and the dissection of an isolated lymph node from this region was then performed. A total of 100 breast cancer patients underwent lymph node dissection and microsurgical lymph node dissection. The control group comprised samples taken from women who died in accidents and had no a history of cancer. Lymph nodes and vessels were isolated from the adipose tissue of the axillary region by the sonolipodestruction technique using LySonix 3000® ultrasonic device with PulseSelect™. A detailed examination of lymph nodes was carried out using OPTON microscope – OPMI 6 CFC and a set of microsurgical instruments. Color lymphography of isolated afferent lymphatic vessels with 0.5 % methylene blue solution was performed. Along with color lymphography, digital morphometry of the components of the lymphatic system (Image-Pro Plus 6.0) and microsurgical dissection of the lymph node capsule and lymphangion valves were performed.Results. Data on non-metastatic and metastatic lymph nodes were obtained and digitally recorded. When studying the metastatic blockade of the lymphoid lobule and afferent lymphatic vessels by the method of antegrade color lymphography, we revealed the compensatory development of lymphatic bypass – intracapsular neo-lymphatic microangiogenesis that was confirmed by histological studies.Conclusion. Color lymphography reliably determines the areas and the extent of functional perfusion. Post-radiation changes in tissues markedly change the logistics of lymph flow and regional metastasis. The lymph node capsule with metastases undergoes a pathological transformation characterized by the development of a network of lymphatic capillaries, the severity of which depends on the extent of metastatic block. Lymph node metastasis changes the lymphatic hydrodynamics by changing the number of lymphatic vessels and their diameter.