Lymph node revealing solution: is it effective on detecting minute lymph nodes?

Area of Science:

• Oncology
• Surgical Pathology
• Diagnostic Imaging

Background:

• Accurate lymph node staging is crucial for effective cancer treatment and prognosis.
• Conventional lymph node dissection may miss small or subtle metastatic deposits.
• Improving lymph node yield is essential for precise pathological assessment.

Purpose of the Study:

• To evaluate the efficacy of a lymph node revealing solution (LNRS) compared to conventional dissection.
• To assess LNRS's performance in detecting additional lymph nodes, including metastatic ones.
• To determine if LNRS improves lymph node staging in colon, breast, and urinary bladder carcinomas.

Main Methods:

• Prospective study involving 30 cancer cases with <10 lymph nodes detected conventionally.
• Immersion of specimens in LNRS for 6-8 hours followed by dissection.
• Comparison with a control group using conventional dissection and re-dissection, with final LNRS immersion.

Main Results:

• LNRS detected 26 additional lymph nodes, 10 of which were metastatic, significantly increasing yield (p<0.01).
• Mean lymph node size detected by LNRS was smaller (4.2 mm) than conventional methods (6.8 mm).
• Pathologic lymph node stage was altered in 4 cases (3 bladder, 1 breast) due to LNRS findings.

Conclusions:

• LNRS significantly enhances the detection of total and metastatic lymph nodes.
• The solution is effective in identifying small lymph nodes missed by conventional methods.
• LNRS improves accurate cancer staging when conventional lymph node counts are insufficient.