title: Ultrastaging of colorectal cancer by sentinel lymph node mapping technique--a multicenter trial.
abstract: Sentinel lymph node (SLN) mapping accurately diagnoses the status of nodal basin with >95% accuracy in melanoma and breast cancer. A multicenter trial for SLN mapping was performed on 203 patients with colorectal cancer to determine accuracy, upstaging, skip metastasis, and aberrant drainage. Lymphazurin 1% was injected subserosally around the tumor and 1-4 blue staining nodes were marked as SLNs for detailed histological analysis. SLN mapping was successful in 98% of patients with an average of 1.7 SLNs per patient. SLNs were negative in 63% of the patients and positive in 37% of the patients. Skip metastasis was seen in 8 of the patients. Occult micrometastasis was found in 14% of patients. In 5% of the patients, unusual lymphatic drainage lead to an alteration of the extent of lymphadenectomy. This multicenter trial proved that SLN mapping in patients with colorectal cancer is simple, cost effective, and upstages at least 14% of patients from AJCC stage I/II to stage III. These patients may then benefit from adjuvant chemotherapy.
authors.affiliation: McLaren Regional Medical Center, Michigan State University, Flint, USA. ssahadr@aol.com
authors.forename: S
authors.initials: S
authors.lastname: Saha
authors.forename: A
authors.initials: A
authors.lastname: Bilchik
authors.forename: D
authors.initials: D
authors.lastname: Wiese
authors.forename: M
authors.initials: M
authors.lastname: Espinosa
authors.forename: J
authors.initials: J
authors.lastname: Badin
authors.forename: B K
authors.initials: BK
authors.lastname: Ganatra
authors.forename: D
authors.initials: D
authors.lastname: Desai
authors.forename: S
authors.initials: S
authors.lastname: Kaushal
authors.forename: T
authors.initials: T
authors.lastname: Singh
authors.forename: M
authors.initials: M
authors.lastname: Arora
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000379:methods
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue