title: [Bladder cancer and the sentinel node concept].
abstract: OBJECTIVE
  Lymph node status is one of the most important prognostic factors in muscle-invasive bladder cancer. The extent of lymphadenectomy performed in conjunction with cystectomy and the question as to whether this is a staging or therapeutic intervention are matters of discussion. The aim of this study was to evaluate the sentinel node (SN) concept and to correlate findings with tumour status in excised regional lymph nodes.
  
  
  METHODS
  26 patients scheduled for cystectomy were investigated with preoperative lymphoscintigraphy, peroperative dye detection (Patent Blue) and dynamic lymphoscintigraphy (Nanocoll or Albures 50 MBq/ml). The substances were injected adjacent to the tumour in the detrusor muscle.
  
  
  RESULTS
  Sentinel nodes were detected in 21 of the 26 of the investigated patients. 7/21 SN were located outside the obturator fossa. Of the eight patients with lymph node metastasis, five displayed metastasis in lymph nodes outside the obturator fossa. There was one false negative SN in a patient with multifocal tumour, while in the other seven patients with lymph node metastasis, these were detected in the SN.
  
  
  CONCLUSIONS
  Sentinel node detection is possible in most cases of bladder cancer scheduled for cystectomy. The significance of utilizing this method to detect lymph node metastasis outside the obturator fossa warrants further investigation.
authors.affiliation: Urologische Klinik, Universitätskrankenhaus Lund, Lund, Sweden. fredrik.liedberg@skane.se
authors.forename: F
authors.initials: F
authors.lastname: Liedberg
authors.forename: G
authors.initials: G
authors.lastname: Chebil
authors.forename: T
authors.initials: T
authors.lastname: Davidsson
authors.forename: P-U
authors.initials: PU
authors.lastname: Malmström
authors.forename: A
authors.initials: A
authors.lastname: Sherif
authors.forename: M
authors.initials: M
authors.lastname: Thörn
authors.forename: M
authors.initials: M
authors.lastname: De La Torre
authors.forename: W
authors.initials: W
authors.lastname: Månsson
mesh_terms: D015653:Cystectomy; D003558:Cystoscopy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D001749:Urinary Bladder Neoplasms / Q000601:surgery*