Use of the gamma probe in sentinel lymph node biopsy in patients with prostate cancer.
OBJECTIVE
To describe the reproducibility of the sentinel lymph node technique in patients with prostate cancer and verify if there is improved accuracy over modified lymphadenectomy.


METHODS
Twenty-three patients with biopsy proven prostate cancer were enrolled in this study. Lymphoscintigraphy was performed after the transrectal administration of Tc sulfur colloid guided by ultrasound, with one injection in each prostate lobe. Images were obtained 15 and 180 min after injection. Sentinel lymph node was harvested during surgery using a gamma probe, followed by extended lymphadenectomy.


RESULTS
The mean age of the patients in this study was 66 years. An average of 3.36 sentinel lymph nodes was found for each patient. Radioactive lymph nodes were identified by the gamma probe in 21 out of 23 patients. In one of the patients there was no radiopharmaceutical migration from the injection site and in another the sentinel lymph node was visualized by lymphoscintigraphy but was not found during surgery. Three patients had lymph node metastasis; in one of these patients the sentinel lymph node was the only positive node and was found outside the modified lymphadenectomy region (obturator fossa and the external iliac).


CONCLUSIONS
Sentinel lymph node biopsy in prostate cancer adds important information to the staging of patients, not always attained through the lymphadenectomy restricted to the obturator fossa and external iliac. Such information is essential for the choice of the best treatment to be applied.
Silva
Neivo
N
Nuclear Medicine Laboratory, and Department of Urology, Complexo Hospitalar Santa Casa de Porto Alegre, Brazil. neivojr@terra.com.br
Anselmi
Carlos E
CE
Anselmi
Osvaldo E
OE
Madke
Rafael R
RR
Hunsche
Angela
A
Souto
Jose S
JS
Souto
Carlos A V
CA
Sica F
Dante
D
Pioner
Giovani T
GT
Macalos
Edson C
EC
Hartmann
Antonio A
AA
Lima
Mauricio S
MS
D000368:Aged; D001706:Biopsy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation / Q000379:methods*; D013667:Technetium
D019275:Radiopharmaceuticals; D013667:Technetium