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Japanese Journal of Clinical Oncology Advance Access published online on November 7, 2005
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi182
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© 2005 Foundation for Promotion of Cancer Research
Received July 11, 2005
Accepted September 20, 2005

Original Article

Is there any Role for Sentinel Node Mapping in Colorectal Cancer Staging? Personal Experience and Review of the Literature

C. Codignola 1*, F. Zorzi 2, A. Zaniboni 3, S. Mutti 1, A. Rizzi 3, E. Padolecchia 2, and G. B. Morandi 1

1 Department of General Surgery, Casa di Cura Poliambulanza, Brescia, Italy
2 Department of Pathology, Casa di Cura Poliambulanza, Brescia, Italy
3 Department of Clinical Oncology, Casa di Cura Poliambulanza, Brescia, Italy

* To whom correspondence should be addressed.
C. Codignola, E-mail: ccodi{at}tin.it


  Abstract

Background: We explored the role of lymphatic mapping and sentinel lymphadenectomy (originally described for melanoma and breast cancer) in colon cancer. Pathologic techniques can successfully identify micrometastatic disease in lymph nodes, but they are not suitable for clinical routine use. We evaluated the role of sentinel node (SN) mapping in refining the staging of colorectal cancer.

Methods: A total of 56 open colorectal resections were performed, and Patent Blue V dye was injected under the serosa surrounding the tumor immediately after opening the abdomen. SNs were analysed by immunohistochemistry to find micrometastatic disease. A literature search for the role of SNs in colorectal cancer was also performed.

Results: We identified the SN in 100% of patients, with a mean of 2.02 SNs/patient (range 1-5). After immunohistochemical staining, we could upstage 21 out of 56 patients (37.5%), and we observed 10.7% false negative SNs (6/56 patients). Fewer than half of the articles described false negative rates of <15%, and most articles showed an upstaging rate of >5% of patients. These differences are probably the result of different sensitivities of the methods used in identifying the lymph node micrometastases.

Conclusions: SN mapping is an easy and cost-effective technique that holds promise and warrants further investigations.

Keywords: sentinel lymph node biopsy; colorectal surgery; colorectal carcinoma; lymphatic metastasis; colonic neoplasms.
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