Related Experiment Video
Updated: Jun 6, 2026
05:52
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Intraoperative sentinel node identification and sampling in clinically node-negative renal cell carcinoma: initial
A Bex1, L Vermeeren, W Meinhardt
1Division of Surgical Oncology, Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. a.bex@nki.nl
World Journal of Urology
|November 26, 2010
Summary
Preoperative SPECT/CT imaging successfully identified sentinel lymph nodes (SNs) in 70% of renal cell carcinoma patients, enabling safe intraoperative sampling. This technique aids in mapping lymphatic drainage for potential diagnostic and therapeutic implications.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Oncology
Background:
- Renal cell carcinoma (RCC) management often involves assessing regional lymph node involvement.
- Accurate staging and identification of lymphatic spread are crucial for treatment planning and prognosis.
- Sentinel lymph node (SN) biopsy is a minimally invasive technique to evaluate metastasis in regional lymph nodes.
Purpose of the Study:
- To evaluate the utility of single-photon emission computed tomography/computed tomography (SPECT/CT) for preoperative sentinel lymph node (SN) identification in renal tumors.
- To assess the surgical feasibility and safety of intraoperative SN sampling guided by SPECT/CT imaging.
- To investigate the anatomical distribution of SNs in renal cell carcinoma patients.
Main Methods:
- A retrospective analysis of 20 patients undergoing SPECT/CT for SN identification after injection of 99mTc-nanocolloid into the renal tumor.
- Intraoperative SN sampling using a gamma probe and portable camera, alongside locoregional lymphadenectomy.
- Evaluation of surgical parameters including approach, time, blood loss, yield, complications, and correlation of SN location with preoperative imaging.
Main Results:
- SPECT/CT successfully identified SNs in 14 out of 20 patients (70%), with 4 cases not visualized on planar lymphoscintigraphy.
- A total of 26 SNs were identified, predominantly in the para-aortic region (17), with aberrant drainage to retrocaval, hilar, celiac, mediastinal, and pleural nodes.
- Intraoperative identification and excision of SNs were feasible with a mean additional operative time of 20 minutes, and no tumor involvement was found in harvested nodes.
Conclusions:
- Preoperative SPECT/CT combined with intraoperative SN sampling is a safe and feasible approach for renal cell carcinoma.
- While para-aortic nodes are common SNs, aberrant lymphatic drainage patterns exist and require consideration.
- Further research is needed to establish the diagnostic and therapeutic impact of precise lymphatic mapping in RCC.
