title: The predictive accuracy of sentinel nodes mapping in the setting of pulmonary metastasectomy.
abstract: This is the first study to evaluate the feasibility of mediastinal lymph node dissection (MLND) based on sentinel lymph node (SLN) status during pulmonary metastasectomy. A total of 22 patients (16 men, 6 women; age 63.3 ± 7.01 years) who were candidates for metastasectomy through segmentectomy or lobectomy with MLND owing to cancers metastatic to the lung were enrolled in this study. Radiotracer was administered at the peritumoral region before surgery or soon after initiating surgery. During the operation, the radioactivity of the lymph nodes (ex vivo) was counted with a handheld gamma probe after MLND. Lobectomy was performed in 17 patients, and segmentectomy, in 5 patients. The number of dissected lymph nodes per patient was 14.4 ± 8.69 (range, 5-36). In all patients, the SLN could be detected, and the number of SLNs identified was 2.0 ± 1.15 (range, 1-5) per patient. Lymph node metastasis was identified in 3 of the 22 patients (13.6%), and none of the 3 patients with N1 or N2 disease had false-negative SLNs. SLN identification might be an indicator of whether or not MLND should be performed during pulmonary metastasectomy. However, further large-volume and multi-institutional studies are needed.
authors.affiliation: Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, 97 Guro-donggil, Guro-gu, 152-703, Seoul, South Korea. kimhyunkoo@korea.ac.kr.
authors.forename: Hyun Koo
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Departments of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Kwanghyoung
authors.initials: K
authors.lastname: Lee
authors.affiliation: Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, 97 Guro-donggil, Guro-gu, 152-703, Seoul, South Korea.
authors.forename: Kook Nam
authors.initials: KN
authors.lastname: Han
authors.affiliation: Departments of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Eo
authors.affiliation: Departments of Nuclear Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Sungeun
authors.initials: S
authors.lastname: Kim
authors.affiliation: Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, 97 Guro-donggil, Guro-gu, 152-703, Seoul, South Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Choi
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D016586:Granular Cell Tumor / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging / Q000295:instrumentation; D019275:Radiopharmaceuticals; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation / Q000379:methods*; D013667:Technetium; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D013667:Technetium
keywords: Cancers metastatic to the lung; Mediastinal lymph node dissection; Metastasectomy