Table 4

Summary of non-duplicate lymphatic mapping and SN biopsy studies in CRCs

First author, year (ref)Number of casesIdentification 
 ratesFalse negative ratesUpstaged by enhanced SN pathologyMethod usedComment (definition of SNs, range of SNs, pathology details)
The false negative rate is defined as the number of SN negative but LN positive cases divided by the number of all LN positive cases. The upstaging rate is defined as the number of SN positive cases positive by enhanced pathology only divided by the number of cases found to be SN negative by standard assessment.
CK, cytokeratin; CRC, colorectal cancer; HE, haematoxylin and eosin; IHC, immunohistochemistry; LN, lymph node; NA, not applicable; NI, not indicated; RT-PCR, reverse transcription polymerase chain reaction; SN, sentinel node; SS, serial sections.
Thörn, 2000 (93)1010/10 (100%)1/? (≥10%)NISubserosal dye and radiocolloid in vivo, in vivo search for blue SNs and ex vivo search for radioactive SNsAny blue LN identified in vivo and high activity LNs defined as SN (range, NI); pathology details NI
Evangelista, 2002 (94)1110/11 (91%)1/3 (33%)NASubserosal dye (submucosal for distal rectal cancers) in vivo, in vivo search for LNsFirst to third blue LN defined as SN (range, 0–3); HE of all LNs
Tsoulias, 2002 (95)1414/14 (100%)1/3 (33%)2/13 (15%)Endoscopic submucosal dye in vivo, in vivo laparoscopic search for SNsFirst blue LNs defined as SNs (range, 1–3); SS, IHC of SNs
Bendavid, 2002 (96)2018/20 (90%)0/12? (0%)5/11? (45%)Subserosal dye in vivo, in vivo search for SNsAny blue LN defined as SN (range, NI; mean, 3.9); SS, IHC of SNs
Waters, 2000 (97)2220/22 (91%)2/3 (66%) HE 
 0/6 (0%) IHC1/15 (7%)Subserosal dye in vivo, in vivo search for SNsAny blue LN identified in vivo defined as SN (range, NI); IHC of HE negative SNs
Cserni, 1999 (38)2524/25 (96%)5/13 (38%) HENASubserosal dye in vivo, ex vivo search for SNsAny blue LN (range, 0–12) defined as possible SN; HE staining of all LNs
Merrie, 2001 (90)2623/26 (88%)3/7 (43%) HE 
 5/11 (45%) RT–PCR2/16 (13%)Subserosal dye and radiocolloid in vivo, ex vivo search for SNsHigh radioactivity LNs or first blue LNs by tracing efferent and afferent lymphatic vessels (range, 0–8); HE and CK-20 RT-PCR of half LNs for all LNs
Wong, 2001 (98)2624/26 (92%)5/12 (42%) HE 
 1/16 (6%) IHC4/12 (33%)Submucosal dye ex vivo, then search for SNsAny blue LN defined as SN (range, 0–6); IHC of negative SNs
Firtzgerald, 2002 (99)2623/26 (88%)2/7 (29%) IHC2/20 (10%)Subserosal dye (submucosal for rectal cancers) ex vivo, search for blue LNsAny blue LN defined as SN (range, NI);3 level HE and IHC of SNs
Esser, 2001 (100)3118/31 (58%)1/3 (33%)NASubserosal dye in vivo (ex vivo for distal rectal cancers, ex vivo search for SNsAny blue LN defined as SN (range, NI); HE for all LNs
Kitagawa, 2000 (101)3328/33 (85%)2/8 (25%)NAEndoscopic submucosal radiocolloid in vivo, in vivo search for SNsRadioactive LNs defined as SNs (range, NI; mean, 3.7); HE for all LNs
Feig, 2001 (102)4847/48 (98%)10/16 (63%) HE 
 5/20 (20%) IHC4/31 (13%)Subserosal dye in vivo, in vivo and ex vivo search for blue LNsAny blue LN defined as SN (range, 0–7); SS and IHC of SNs
Joosten, 1999 (61)5035/50 (70%)12/20 (60%) HE2/15 (13%)Subserosal dye (submucosal for distal rectal cancers) in vivo, ex vivo search for blue LNsAny blue LN defined as SN (range, 0–16); CK IHC of HE negative blue LNs
Paramo, 2002 (103)5545/55 (82%)1/15 (7%)6/36 (17%)Subserosal dye in vivo, in vivo search for SNsFirst 1–4 blue LNs defined as SNs (range, 0–1); SS, IHC of SNs
Bilchik, 2002 (86)10097/100 (97%)5/26 (19%) HE18/74 (24%) 2 levels HE and IHC 12/26 (46%) RT–PCR of IHC negative SNsSubserosal dye in vivo, in vivo search for SNs, or salvage subserosal or submucosal dye ex vivo, for failed proceduresAny blue LN defined as SN (range, NI); SS, IHC and/or RT-PCR of SNs
Saha, 2000 (92, 104)131130/131 (99%)4/51 (8%)6/86 (7%)Subserosal dye in vivo, in vivo search for SNsFirst 1–4 blue staining LNs defined as SNs (range, 0–4); SS and IHC of HE negative SNs