A caution regarding lymphatic mapping in patients with colon cancer
Section snippets
Patients and methods
A prospective multicenter study was begun in February 2000 to evaluate the role of LM and SLNB in patients with colon cancer. Any patient with either a biopsy-proven colon cancer or a colon polyp suspicious for potentially harboring an invasive cancer was considered eligible for the protocol. After obtaining informed consent, patients were taken to the operating room, and after general anesthesia was induced, the LM was performed by injecting 3 to 5 cc of isosulfan blue dye (Lymphazurin;
Results
The characteristics of the 48 patients entered into the study are shown in Table 1. On average, 13 nonsentinel lymph nodes (NSLNs) and 2.6 sentinel lymph nodes (SLNs) were identified per patient. In all but 1 (98%) of the patients, at least 1 SLN was identified.
Table 2 outlines the significant tumor characteristics. The tumors were distributed relatively evenly between the right and left colon (46% versus 50%, respectively), with only an occasional patient presenting with a transverse colon
Comments
Several recent studies have suggested that intraoperative LM and SLNB are sensitive and predictive means of pathologically staging patients with colorectal cancer [9], [10]. However, controversy exists regarding both the accuracy and significance of SLNB in patients with colorectal carcinoma [11], [12]. The advantages attained in patients with melanoma and breast cancer—that of eliminating the morbidity of regional lymph node dissection as well as improved staging of patients with
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