Sentinel nodal assessment in patients with carcinoma of the lung.
BACKGROUND
Assessment of sentinel nodes to predict metastases in a regional nodal basin is valuable for staging patients with melanoma and breast carcinoma. This study tested whether injection of isosulfan blue and technetium-99 could identify mediastinal sentinel nodes in patients with lung carcinoma and determine whether sentinel node histology predicts distal nodal metastases.


METHODS
Isosulfan blue and technetium-99 were injected into the tumor and pulmonary resection performed. The hilum and mediastinum were assessed visually and with the gamma probe, and a mediastinal nodal dissection was performed.


RESULTS
Thirty-one patients were evaluated. Three patients had positive sentinel nodes and positive distal mediastinal nodes. Twenty-two patients had negative sentinel nodes and negative distal nodes. No sentinel node was identified in 6 patients and 2 patients had two sentinel nodes.


CONCLUSIONS
These data demonstrate that this rapid, simple technique can identify sentinel nodes in the mediastinum and that the sentinel node is an accurate predictor of distal nodal metastases in patients with lung cancer.
Schmidt
Frank E
FE
Department of Surgery, Louisiana State University Health Sciences Center, New Orleans 70112, USA. fschmi@lsuhsc.edu
Woltering
Eugene A
EA
Webb
Watts R
WR
Garcia
Olga M
OM
Cohen
Joy E
JE
Rozans
Mark H
MH
D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology* / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid
D012394:Rosaniline Dyes; C025484:iso-sulfan blue; D013671:Technetium Tc 99m Sulfur Colloid