Current clinical status of sentinel lymph nodes in colon and proximal rectal cancer

The postoperative report of the lymph node status of colorectal cancer in clinical practice is not a given fact. Among other factors, it is dependent on the experience and technique of the surgeon as well as the pathologist. Therefore a method like sentinel lymph node biopsy (SLNB) that identifies and provides for analysis the lymph node at highest risk for tumour involvement would be highly beneficial. Unlike in breast cancer or melanoma, SLNB is more difficult to apply in colorectal cancer and is still not ready for clinical routine application for these tumor entities. However, careful patient selection and expertise of the involved specialists can improve the quality and results of SLNB in colorectal cancer. Especially in the early stage cancer patients, SLNB may be helpful to identify the earliest signs of lymphatic dissemination (thereby upstaging the patient) or to encourage a limited extent of resection.