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Lymphatic mapping and sentinel lymph node biopsy in epidermoid carcinoma of the anal canal

Item Type:Article
Title:Lymphatic mapping and sentinel lymph node biopsy in epidermoid carcinoma of the anal canal
Creators Name:Gretschel, S. and Warnick, P. and Bembenek, A. and Dresel, S. and Koswig, S. and String, A. and Huenerbein, M. and Schlag, P.M.
Abstract:AIM: Although 15-25% of patients with anal cancer present with superficial inguinal lymph node metastases but the routine application of groin irradiation is controversial because of serious side effects. Inguinal sentinel lymph node biopsy (SLNB) can be used to select patients appropriately for inguinal radiation. The study evaluates the efficiency and clinical impact of SLNB. METHODS: Forty patients with anal cancer underwent 1ml Tc(99m)-Nanocolloid injection in four sites around the tumour. Patients with inguinal radio colloid enrichment were selected for sentinel lymph node biopsy (SLNB). Lymph node status was examined by haematoxylin and eosin (H&E) as well as immunohistochemistry-staining. All SLN-positive patients were scheduled for inguinal radiation; SLN-negative patients with T1 and early T2 tumours were not scheduled for inguinal radiation. RESULTS: SLN were detected in 36/40 patients. Three common patterns of lymphatic drainage were observed: mesenterial, iliacal and inguinal. Twenty patients with inguinal SLN underwent SLN-biopsy. 6/20 patients were SLN-positive. In 10/20 patients SLNB altered the therapy plan - four patients with T1-tumours and positive SLN had additional groin irradiation, whereas 6 patients with small T2-tumors and tumour-free inguinal SLN did not undergo inguinal irradiation. CONCLUSIONS: Inguinal sentinel node biopsy in anal cancer is efficient and could assist in the decision for inguinal radiation. The validity and safety of the proposed therapeutic algorithm has to be proven by a larger, prospective study.
Keywords:Anal Cancer, Sentinel Node Biopsy, Clinical Impact
Source:European Journal of Surgical Oncology
Page Range:890-894
Date:August 2008
Official Publication:https://doi.org/10.1016/j.ejso.2007.11.013
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