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At least 523 records · Page 29Linked to original sources
PubMed2001

Accuracy of sentinel lymph node in papillary thyroid carcinoma.

BACKGROUND: The sentinel lymph node has been used in several tumors. The aim of this study was to analyze the accuracy of the sentinel node in papillary thyroid carcinoma. METHODS: A series of 22 patients with papillary thyroid carcinoma were included. Approximately 0.5 cc of isosulfan blue dye was injected at operation to trace the sentinel node. Lymph node dissection of the ipsilateral central compartment and extensive sampling of the jugular compartment were performed in addition to sentinel node resection. Surgical specimens were stained with hematoxylin-eosin, and negative sentinel nodes were subsequently stained with immunohistochemistry for cytokeratin-7. RESULTS: Mean age was 37 +/- 14 years. Twenty patients were women, and 2 were men. Mean tumor size was 2.5 +/- 1 cm. A sentinel lymph node was found in 20 patients. With use of hematoxylin-eosin, metastases were identified in 12/20 sentinel nodes (60%). Eleven patients with positive sentinel nodes presented additional lymph node metastases: 9 in the central compartment, 1 in the jugular compartment, and 1 in both compartments. Two patients with negative sentinel nodes had lymph node metastases elsewhere. When sentinel nodes were processed by immunohistochemistry, accuracy increased to 100%. CONCLUSIONS: Sentinel node is highly accurate for diagnosing metastases in papillary thyroid carcinoma.

Adult↗
PubMed1999

The sentinel lymph node concept in prostate cancer - first results of gamma probe-guided sentinel lymph node identification.

OBJECTIVE: The goal of this study was to show lymphatic drainage and to verify the validity of lymphoscintigraphy for the identification of the sentinel lymph node (SLN) in prostate cancer. Furthermore, the question is to be raised whether the standardized pelvic lymphadenectomy is a sufficient means for also detecting solitary micrometastases. PATIENTS AND METHODS: Eleven patients with prostate cancer received a sonographically controlled, transrectal administration of a technetium-99m colloid injected directly into the prostate 1 day prior to pelvic lymphadenectomy. 20 min later the dynamic lymphoscintigraphy was carried out. During surgery, the SLNs were identified by using a gamma probe. The standard pelvic lymphadenectomy was performed after removal of the SLN. RESULTS: In 3 of 4 patients with micrometastasis the spread of the tumor could exclusively be found in those nodes which had been identified as SLNs by means of scintigraphy by combining preoperative lymphoscintigraphy and intraoperative gamma probe detection. In 2 cases, the pathologically proved SLNs were situated at the anteromedial region of the internal iliac artery, thus being located outside of the standard pelvic lymphadenectomy area. In 1 patient, however, the micrometastasis was found beyond those nodes which had been identified as SLN intraoperatively. CONCLUSIONS: In the future, we expect the restriction of pelvic staging lymphadenectomy to scintigraphically proved SLN. The perioperative morbidity may be reduced by increasing the sensitivity of the detection of micrometastases. Our data confirm earlier perceptions, according to which even modified standardized pelvic lymphadenectomy is considered insufficient in terms of the detection of micrometastases.

Aged↗
PubMed2005

Subjective morbidity and quality of life after sentinel node biopsy and axillary lymph node dissection for breast cancer.

BACKGROUND AND OBJECTIVES: Sentinel node (SN) biopsy is a minimally invasive surgical method for axillary staging in patients with breast cancer. The aim of this study was to evaluate mid-term morbidity after SN biopsy and axillary lymph node (ALN) dissection in patients with breast cancer receiving breast-sparing treatment, and to determine its impact on quality of life (QOL). METHODS: One hundred fifteen patients with breast cancer underwent breast-conserving treatment with SN biopsy alone (Group 1: n = 54), ALN dissection with or without SN biopsy (Group 2: n = 51), or SN biopsy followed by later ALN dissection (Group 3: n = 10). RESULTS: The mean post-operative follow-up was 20.3 months (range: 10-31 months) in Group 1, 24.3 months (range: 10-33 months) in Group 2, and 19.1 months (range: 12-28 months) in Group 3. Arm-shoulder pain was reported by 21.2% of patients in Group 1, 52.9% in Group 2, and 60% in Group 3 (P = 0.002). An arm swelling sensation was reported by 0% of patients in Group 1, 21.6% in Group 2, and 10% in Group 3. Dysesthesias were reported by 5.7% of patients in Group 1, 51% in Group 2, and 50% in Group 3 (P < 0.001). The mean global QOL self-rating score was 7.6 in Group 1, 7.6 in Group 2, and 7.7 in Group 3 (no significant difference). CONCLUSIONS: SN biopsy is associated with significantly lower mid-term morbidity than ALN dissection.

Adult↗
PubMed1987

Metastases in small lymph nodes from colon cancer.

Lymph node metastases are important determinants in the prognosis of primary colorectal cancer. Although it has been established that enlarged, palpable lymph nodes contain metastases in less than half of the cases, no definitive data concerning the incidence of metastases in lymph nodes measuring 5 mm or less are available. We treated the surgical specimens of 52 consecutive patients who had colon cancer with a lymph node clearance technique at the Roswell Park Memorial Institute, Buffalo. We found 2699 lymph nodes in the 52 specimens, with a mean of 52 lymph nodes per specimen (range, five to 151). Sixty-four lymph nodes were found with metastases in 21 (40%) of the 52 patients. Fifty-nine of 64 of the lymph nodes were reexamined and remeasured. Thirty-nine lymph node metastases measured less than 5 mm, 13 were between 5 and 10 mm, and eight were larger than 10 mm. We concluded that lymph node metastases in colon cancer occur most frequently in lymph nodes measuring less than 5 mm (small lymph nodes). The use of lymph node clearing techniques in surgical specimens improves detection of small lymph node metastases and thereby diminishes understaging.

Colonic Neoplasms↗
PubMed2005

Cosmetic outcome of breast conserving therapy after sentinel node biopsy versus axillary lymph node dissection.

INTRODUCTION: Next to locoregional control, good cosmetic outcome is one of the main goals of breast conserving treatment (BCT) for breast cancer surgery. Factors affecting cosmetic outcome are well known. The sentinel node (SN) procedure avoids lymphedema in the breast, which might influence cosmetic outcome. The aim of this study was to evaluate the cosmetic outcome of BCT after the SN procedure compared to that after axillary lymph node dissection (ALND). METHODS: The subjects were 20 patients who underwent ALND and 20 patients who underwent the SN procedure. After a minimum follow-up period of 43 months, we photographed each patient. Fifteen healthy women served as control subjects. We used the percentage breast retraction assessment index (pBRA=BRA/reference length x 100) to compare cosmetic outcome. RESULTS: The median pBRAs of the ALND group and SN group (14.3 and 6.71, respectively) significantly differed ( p=0.001). The pBRA of the SN group was comparable to the pBRA (6.1) of the control group ( p=0.317). CONCLUSION: Cosmetic outcome of BCT after the SN procedure was superior compared to the cosmetic outcome after ALND. This is an important additional reason to implement the SN procedure in routine daily practice.

Axilla↗
PubMed1984

Lymphocyte recognition of lymph node high endothelium. VI. Evidence of distinct structures mediating binding to high endothelial cells of lymph nodes and Peyer's patches.

Lymphocytes migrate from blood into lymph nodes (LN) and Peyer's patches (PP) of rats specifically at segments of venules lined by high endothelium (HEV). We previously identified and isolated a lymphocyte surface component termed high endothelial binding factor (HEBF) that appears to be involved in lymphocyte adhesion to high endothelial cells of LN. HEBF has also been isolated from thoracic duct lymph and is antigenically related to the cell surface component. Soluble HEBF derived from detergent lysates of thoracic duct lymphocytes (TDL) or directly from lymph has affinity for HEVLN in vitro, and is able to block sites where lymphocytes would normally attach. In the present study, lymphocyte binding sites of HEVLN and HEVPP were investigated through the use of lymph-derived HEBF and rabbit antibody to this factor. The results show that treatment of rat TDL with anti-HEBF Fab did not block binding to HEVPP, even though adhesion to HEVLN was reduced by 80% or more. Similarly, HEBF isolated by anti-HEBF F(ab')2 affinity chromatography blocked lymphocyte binding sites of HEVLN but not HEVPP. This material is therefore designated HEBFLN, and antibody to it is designated anti-HEBFLN Ig. Fractionation of thoracic duct lymph revealed that it contained an antigenically distinct component, HEBFPP, which blocked lymphocyte binding to HEVPP but not to HEVLN. Lymph components precipitating between 40 and 60% (NH4)2SO4 saturation contained both factors, which were separated from the bulk of lymph proteins by DEAE-Sepharose chromatography and then from each other by fractionation on the anti-HEBFLN F(ab')2-Sepharose column. The unbound fraction from this column contained HEBFPP, which was then partially purified by CM-Sepharose filtration. HEBFPP appeared to be a glycoprotein because it was destroyed by trypsin, bound to lentil lectin, and was eluted with alpha-methyl-mannoside. Together, the results demonstrate the existence of two antigenically distinct species of HEBF, and imply that lymphocyte binding sites of HEVLN and HEVPP are structurally different. We interpret the results to mean that distinct high endothelial adhesion molecules on lymphocytes mediate their entry into LN and PP.

Animals↗
PubMed1983

Cervical lymph node metastases: the significance of the level of the lymph node.

Two thousand and fifty-eight patients with squamous carcinoma of the head and neck are described. Thirty-five per cent of these patients had a node in the neck at the time of presentation. The level of the node was dictated by the primary tumour: other factors such as T or N status were not significant predictors of node level. Node level was a highly significant predictor of survival, together with age, general condition, node status and site the primary tumour. The 5-year survival for nodes at Level I (submandibular) nodes was 34%, and only 4% for nodes at Level IV.

Aged↗
PubMed2004

Imprint cytology for detecting metastasis of lung cancer in mediastinal lymph nodes.

BACKGROUND: Lymph node metastasis of lung cancer has been evaluated with histologic examination. We studied the usefulness of cytologic diagnosis for detecting metastasis of lung cancer in mediastinal nodes. METHODS: Five hundred twelve stations of mediastinal nodes in 157 patients with lung cancer were excised for staging of the disease through mediastinoscopy or thoracoscopy. Among them, 474 stations of mediastinal nodes in 151 patients were examined for metastasis both with imprint cytology and with hematoxylin-eosin histology independently. The final diagnostic decision was made by overall pathologic information, including cytology and histology. The diagnostic accuracies were compared between cytologic and histologic examinations. RESULTS: Cytologic examination identified 66 positive stations and 2 suspicious stations in 45 patients, whereas histologic examination identified 61 positive stations in 42 patients. The final pathologic diagnosis was 70 positive stations and 1 suspicious station in 45 patients. The sensitivity, accuracy, and negative predictive value of cytologic examination for node metastasis were 95.7%, 99.4%, and 99.3%, respectively, and those of histologic examination were 87.1%, 98.1%, and 97.7%, respectively. On a patient basis the sensitivity, accuracy, and negative predictive value of cytologic examination were 100%, 100%, and 100%, respectively, whereas those of histologic examination were 93.8%, 98.0%, and 97.2%, respectively. An additional 3 patients (2.0%) who had contralateral mediastinal node metastasis diagnosed only with cytology were identified with upstaged disease. CONCLUSIONS: Imprint cytology for detecting metastasis of lung cancer in mediastinal nodes has high sensitivity and accuracy and is no less useful than histologic examination.

Adult↗
PubMed1994

[Adjuvant treatments of early breast cancer without lymph node involvement].

Lymph node status remains the most important prognostic factor in breast cancer. However, only 70% of the node negative breast cancer patients are alive at 10 years. Several randomized trials have shown that systemic adjuvant therapy, either chemo or hormonotherapy, increases survival in these patients. A recent meta-analysis confirms these findings. In 1992, a consensus conference recommended no therapy in low risk patients (tumor size less than 1 cm), tamoxifen in good risk patients (tumor less than 2 cm, oestrogen or progesterone receptors positive, well differentiated) and chemotherapy in premenopausal or hormonotherapy in postmenopausal high risk patients (receptor-negative less than 1 cm tumor or high pathological grade).

Breast Neoplasms↗
PubMed1999

Clinical significance of intramammary lymph nodes.

Intramammary lymph nodes (IMLN) are present in up to 47% of breasts and may be involved in metastatic disease in up to 9.8 % of operable breast cancer cases. IMLN are likely to be increasingly recognized with wider acceptance of high quality screening mammography and the use of ultrasound assessment of breast disease. The aim of this study is to demonstrate how IMLN can have an impact on management of breast cancer patients by presenting a case series of three patients. We conclude that IMLN metastases from breast cancer alters the prognosis and hence the management of patients. This will need to be addressed more frequently as sentinel node biopsy is more widely utilized.

Journal Article↗
PubMed2000

Appraisal of surgical resection of gallbladder cancer with special reference to lymph node dissection.

BACKGROUND: Radical lymph node dissection in surgery for advanced gallbladder cancer is controversial. The purpose of this study is to evaluate the role of lymph node dissection based on the clinico-pathologic results. PATIENTS: Seventy-three patients who underwent radical surgery including systematic dissection of the N1+N2 region lymph node plus some of the para-aortic nodes were reviewed. RESULTS: pT1 patients had no lymph node metastasis, but pT2 and pT3/pT4 patients had lymph node metastasis at a rate of 50.0% (13/26) and 83.3% (25/30), respectively. As infiltration of the hepatoduodenal ligament (Binf) became severe, the rate and extent of lymph node metastasis increased. There were four 5-year survivors with lymph node involvement. The 5-year survival rates are 77.0% in pN0 cases and 27.3% in pN1 cases (P<0.01). There was no difference in survival between pN1 and pN2 patients. However, significant differences in survival were observed between pN0/1 and pN2/3 patients when these patients were limited to Binf0/1. Examination of the recurrence pattern showed that most patients with pN0/1/2 had no regional lymph node recurrence, but there was para-aortic lymph node recurrence in patients with pN3 outside the dissected region. Significant prognostic factors influencing survival after surgery by multivariate analysis were pN2/3, pT, and residual tumor. CONCLUSION: Systematic lymph node dissection of N1, N2, and part of the para-aortic region improves survival in advanced gallbladder cancer patients, especially in those without either para-aortic lymph node metastases or Binf2/3.

Adult↗
PubMedDate not supplied

The new imaging-based classification for describing the location of lymph nodes in the neck with particular regard to cervical lymph nodes in relation to cancer of the larynx.

For over five decades, the principle landmarks used in cervical nodal classification were clinical and defined either by palpation or found at the operative table. However during the past two decades, sectional imaging has consistently improved its quality and resolution and it has been shown that imaging can identify deep structures and adenopathy not amenable to palpation. Such disease can alter planned operative or radiation fields. In the April 1999 issue of the Archives of Otolaryngology-Head Neck Surgery, for the first time an imaging-based classification was published that gave precise anatomic landmarks for use in classifying metastatic cervical adenopathy. This classification was developed in consultation with head and neck surgeons so that the nodal levels classified by this imaging-based system would correspond closely with the nodal levels determined by utilizing the most commonly employed clinically-based classifications. This article describes this imaging-based classification and demonstrates its use with axial diagrams.

Head and Neck Neoplasms↗
PubMed2004

[Our experience with the sentinel lymph node detection].

BACKGROUND: Axillary lymph node staging is the most powerful predictor of survival in breast cancer women. Sentinel lymph node biopsy (SLNB) is more accurate method in evaluation of axillary lymph node staging than complete axillary lymph node dissection (CALND) because of more precious histological and imunohistochemical assessment of the first draining lymph nodes. Furthermore, SLNB eliminates complications resulting from CALND. MATERIAL AND METHODS: SLNB is either performed using blue dye technique or using of combination of blue dye and radioguided technique. We prefer two days protocol in application of Tc 99 radiocolloid. There were used both techniques for detection sentinel lymph nodes and results were compared. RESULTS: There were performed 21 SLNBs using blue dye technique, Group A, and 20 SLNBs using combination of blue dye and radioguided technique, Group B, from October 2001 to November 2003. Sentinel lymph nodes were not detected in Group A in two cases, false negativity occurred two times in this group. Sentinel lymph nodes were detected in all cases in Group B and there was no false negativity present in this group. CONCLUSION: Combination of blue dye and radioguided technique is more precious in detection of sentinel lymph node than blue dye technique itself. Two days protocol of application of Tc 99 radiocolloid enables performing this method even in hospitals, where the Department of Nuclear Medicine is not available.

Adult↗