[Sentinel lymph node mapping in patients with colorectal cancer]

The colorectal cancer is the most frequent and clinically significant tumor of the gastrointestinal tract. For more than 100 years, radical lymphadenectomy has been the diagnostic and therapeutic gold standard for the management of metastatic nodal disease. More than 50% of patients are initially present with I and II stage of the disease. About 15% to 30% of these patients develop regional or distant metastases within 5 years of diagnosis. This might be because of the pathological understaging, which may occur due to presence of occult micrometastases, smaller than 5 mm. SLN mapping and biopsy is estbilished as tool for accurate nodal staging. The purpose of this study is to present and analyse the data from the expirience in SLN mapping in colorectal cancer, at the same time to be done a description of the applicated method. We used the dye-method with Patent Blue V to patients with verificated colorectal cancer.

Our study showed that the SLN mapping technique with Patent Blue V is technically simple, quick (usually 5-10 minutes of operating time) and cost effective. It is highly successful (100%), highly sensitive (92%), the SN's status predict the status of the whole regional lymph basein in 67% of the patients. False-negative results are obtained in 8% of the patients. We upstaged the clinical stage of the disease from II to III stage in 4% of the patients, after focused investigation with cytokeratin. We increase the extent of the surgery in 4% of the patients because we found positive SNs beyond the borders of standart resection. SLN mapping and intraoperative detection is an approach, which could increase the possibilities for more accurate nodal staging and it is feasible diagnostic tool in the hands of the surgeon in management of the oncological diseases and colorectal cancer.