[Sentinel node metastasis in the case of colorectal cancer. No role for sentinel node biopsy at present].
With sufficient experience, sentinel node biopsy has a high identification rate for several techniques in the case of colorectal cancer. However, the sensitivity of the procedure seems to be too low to justify the replacement of routine pathological examination of the whole mesentery by sentinel node biopsy. Unexpected lymphatic drainage patterns can be found in about 5% of the patients. Therefore, the role of sentinel node biopsy in determining the extension of the resection is minimal in the case of colorectal cancer. In contrast, sentinel node biopsy is helpful in identifying the lymph nodes with the highest risk of harbouring metastases and it facilitates the scrutinising of the lymph node by the pathologist. This will lead to more micrometastases being detected. The prognostic significance of micrometastases and the impact on survival of adjuvant systemic therapy in such patients should be investigated in randomised controlled trials. At present, sentinel node biopsy in colorectal cancer should be restricted to a research setting.
Tanis
P J
PJ
Sint Lucas Andreas Ziekenhuis, afd. Chirurgie, Jan Tooropstraat 164, 1061 AE Amsterdam. p.tanis@slaz.nl
Steller
E Ph
EP
D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D009367:Neoplasm Staging; D011379:Prognosis; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy