title: Sentinel node detection in renal cell carcinoma. A feasibility study for detection of tumour-draining lymph nodes.
abstract: OBJECTIVE
  To evaluate the feasibility of performing sentinel node detection in patients with renal cell carcinoma (RCC).
  
  
  METHODS
  An open series of 13 arbitrarily selected patients with T1b-T3b RCC scheduled for radical nephrectomy at a single Tertiary Academic Centre were examined with different modalities of sentinel node detection. Preoperative ultrasonography-guided injection of radioactive isotope, lymphoscintigram and single photon emission computed tomography/computed tomography, followed by intraoperative gamma-probe detection and Patent Blue detection, as well as postoperative scintigram of the main specimen were the planned interventions. These investigations were performed in conjunction with intended open radical nephrectomy.
  
  
  RESULTS
  In 10 of the 13 patients sentinel node detection was achieved with 32 sentinel nodes displayed. Radio-guided surgery using an intraoperative gamma-probe resulted in the highest realtive detection rate with detection of sentinel nodes in nine patients. In total, nine metastatic sentinel nodes were detected in three patients. One patient, preoperatively staged as N+, was restaged after sentinel node detection and histopathology as pN0.
  
  
  CONCLUSIONS
  Sentinel node detection in renal tumours is feasible although evaluation of different modes of detection needs further refinement and standardization. All nodes preoperatively detected by routine computed tomography as suspicious metastatic lesions were confirmed as sentinel nodes, including two nodes considered as metastatic by preoperative routine imaging but ultimately staged as non-metastatic sentinel nodes.
authors: Department of Urology, Karolinska University Hospital, Stockholm, Sweden. amir.sherif-abdel-hadi@karolinska.se
authors: Amir M
authors: AM
authors: Sherif
authors: Elisabeth
authors: E
authors: Eriksson
authors: Magnus
authors: M
authors: Thörn
authors: Janos
authors: J
authors: Vasko
authors: Katrine
authors: K
authors: Riklund
authors: Lars
authors: L
authors: Ohberg
authors: Börje J
authors: BJ
authors: Ljungberg
mesh_terms: D000005:Abdomen; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D009392:Nephrectomy; D011446:Prospective Studies; D011859:Radiography; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*