Targeted lymph node examination improves staging of co...( s from the spaces between body tissues....),Health

s from the spaces between body tissues. The tumor, sentinel nodes and other lymph nodes in the region were then removed and examined. "The sentinel node paradigm is based on the premise that lymphatic drainage from a primary organ site occurs in an orderly and progressive fashion," the authors write. "The sentinel lymph node is the first node to receive lymphatic drainage from a primary anatomical site and is therefore the most likely node to harbor a metastasis."

Of the 132 participants, 33 (30 percent) had stage I cancer, 46 (41 percent) had stage II and 32 (29 percent) stage III. Twenty-eight patients (23.6 percent) were classified at a more severe stage based on the analysis of sentinel nodes. The sensitivity of the lymphatic mapping/sentinel node procedure was 88.2 percent, meaning that 45 of 51 patients whose cancer had spread to their lymph nodes had tumors in their sentinel nodes. False negatives, when an individual's cancer had spread to lymph nodes but was not detected in the sentinel node, occurred in six of 81 (7.4 percent) of patients who were determined to be node negative. Eighteen percent of the sentinel nodes had tumors, compared with 6 percent of the other lymph nodes.

The results "suggest that lymphatic mapping and sentinel lymph node techniques are feasible and accurate in colon cancer," the authors write. "The improved risk stratification afforded by standardization of both surgical and pathological techniques may improve the selection of patients for chemotherapy, thereby avoiding the unnecessary toxic effects and expense for those cured by surgery alone."

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Contact: Trace Longo
714-600-9811
JAMA and Archives Journals
19-Jun-2006

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