A multicenter trial of sentinel lymph node mapping in colorectal cancer: prognostic implications for nodal staging and recurrence.
BACKGROUND
Sentinel lymph node (SLN) mapping (M) for staging in colorectal cancer (CRCa) remains controversial and needs to be validated. This study analyzes results of SLNM at a multi-institutional level for CRCa.


METHODS
Group A patients underwent SLNM with 1 to 3 mL of 1% lymphazurin. First 1 to 4 blue lymph nodes were designated as SLNs and had focused analysis. Group B had standard resection and nodal staging. Patients with a minimum of 2 years of follow-up were analyzed for recurrence.


RESULTS
Overall nodal metastasis were 50% for 500 group A patients versus 35% for 368 group B patients. In SLNM patients success, accuracy, sensitivity, and negative predictability values were 98%, 96%, 90%, and 93%, respectively. With a 2-year minimum follow-up, 153 group A patients had 7% recurrences compared with 25% in 162 group B patients.


CONCLUSIONS
SLNM is highly feasible and accurate for staging CRCa with higher detection of nodal metastasis and lower recurrences.
McLaren Regional Medical Center, Michigan State University, 3500 Calkins Road, Suite A, Flint, MI 48532, USA. ssahadr@aol.com
Sukamal
S
Saha
Rajesh
R
Sehgal
Rajesh
R
Seghal
Mehul
M
Patel
Kiet
K
Doan
Adrian
A
Dan
Anton
A
Bilchik
Thomas
T
Beutler
David
D
Wiese
Nader
N
Bassily
Charles
C
Yee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D018709:Statistics, Nonparametric