Document Detail


Current status of sentinel lymph node navigation surgery in breast and gastrointestinal tract.
MedLine Citation:
PMID:  17380009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sentinel lymph node biopsy (SLNB) has been developed as a new diagnostic and therapeutic modality in melanoma and breast cancer surgery. The purpose of the SLNB include preventing the operative morbidity and improving the pathologic stage by focusing on fewer lymph nodes using immunocytochemic and molecular technology has almost achieved in breast cancer surgery. The prognostic meaning of immunocytochemically detected micrometastases is also evaluating in the SLN and bone marrow aspirates of women with early-stage breast cancer. SLNB using available techniques have suggested that the lymphatic drainage of the gastrointestinal tract is much more complicated than other sites, skip metastasis being rather frequent because of an aberrant lymphatic drainage outside of the basin exist. At the moment, the available data does not justify reduced extent of lymphadenectomy, but provides strong evidence for an improvement in tumor staging on the basis of SLNB. Two large scale prospective multi-center trials concerning feasibility of gamma-probe and dye detection for gastric cancer are ongoing in Japan. Recent studies have shown favorable results for identification of SLN in esophageal cancer. CT lymphography with endoscopic mucosal injection of iopamidol was applicable for SLN navigation of superficial esophageal cancer. The aim of surgical treatment is complete resection of the tumor-infiltrated organ including the regional lymph nodes. Accurate detection of SLN can achieve a selection of a more sophisticated tailor made approach. The patient can make a individualized choice from a broader spectrum of therapeutic options including endoscopic, laparoscopic or laparoscopy-assisted surgery, modified radical surgery, and typical radical surgery with lymph node dissection. Ultrastaging by detecting micrometastasis at the molecular level and the choice of an adequate treatment improve the postoperative quality of life and survival. However these issues require further investigation.
Authors:
Akira Tangoku; Junichi Seike; Kiichiro Nakano; Taeko Nagao; Junko Honda; Takahiro Yoshida; Hiromichi Yamai; Hisashi Matsuoka; Kou Uyama; Masakazu Goto; Takanori Miyoshi; Tadaoki Morimoto
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The journal of medical investigation : JMI     Volume:  54     ISSN:  1343-1420     ISO Abbreviation:  J. Med. Invest.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-03-23     Completed Date:  2007-05-01     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9716841     Medline TA:  J Med Invest     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1-18     Citation Subset:  IM    
Affiliation:
Department of Oncological and Regenerative Surgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
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MeSH Terms
Descriptor/Qualifier:
Breast Neoplasms / pathology*,  surgery*
Colorectal Neoplasms / pathology
Esophageal Neoplasms / pathology
False Negative Reactions
Female
Gastrointestinal Neoplasms / pathology*,  surgery*
Humans
Lymphography
Sentinel Lymph Node Biopsy / methods
Stomach Neoplasms / pathology
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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