Department of Urology, Karolinska University Hospital, Stockholm, Sweden.
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden; Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Otago, New Zealand; Department of Medical Biosciences, Pathology, Umeå University, Umeå; Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, University Hospital, Umeå, Sweden.
Study Type - Therapy (case series) Level of Evidence 4.
What's known on the subject? and What does the study add? This is the first presented results and second publication on detection of tumour-draining lymph nodes in human renal cell carcinoma. Techniques are displayed and tumour-draining patterns are presented.
To evaluate the feasibility of performing sentinel node detection in patients with renal cell carcinoma (RCC).
An open series of 13 arbitrarily selected patients with T1b-T3b RCC scheduled for radical nephrectomy at a single Tertiary Academic Centre were examined with different modalities of sentinel node detection. Preoperative ultrasonography-guided injection of radioactive isotope, lymphoscintigram and single photon emission computed tomography/computed tomography, followed by intraoperative gamma-probe detection and Patent Blue detection, as well as postoperative scintigram of the main specimen were the planned interventions. These investigations were performed in conjunction with intended open radical nephrectomy.
In 10 of the 13 patients sentinel node detection was achieved with 32 sentinel nodes displayed. Radio-guided surgery using an intraoperative gamma-probe resulted in the highest realtive detection rate with detection of sentinel nodes in nine patients. In total, nine metastatic sentinel nodes were detected in three patients. One patient, preoperatively staged as N+, was restaged after sentinel node detection and histopathology as pN0.
Sentinel node detection in renal tumours is feasible although evaluation of different modes of detection needs further refinement and standardization. All nodes preoperatively detected by routine computed tomography as suspicious metastatic lesions were confirmed as sentinel nodes, including two nodes considered as metastatic by preoperative routine imaging but ultimately staged as non-metastatic sentinel nodes.
Written by:
Sherif AM, Eriksson E, Thörn M, Vasko J, Riklund K, Ohberg L, Ljungberg BJ. Are you the author?
Reference: BJU Int. 2011 Aug 24. Epub ahead of print.
doi: 10.1111/j.1464-410X.2011.10444.x
PubMed Abstract
PMID: 21883833
UroToday.com Renal Cancer Section
