The Influence of Intraoperative Factors and Histopathological Staging on the Performance of Sentinel Node Biopsy in
D Murawa1, P Nowaczyk, A Spychała
1First Clinic of Surgical Oncology and General Surgery, Wielkopolska Cancer Centre, Poznań, Poland.
Background:
The aim of this study was to assess sentinel node biopsy (SNB) results in colon cancer (CC) regarding intraoperative staging of the disease and pathological cancer features.
Material And Methods:
The study was conducted on the basis of 132 SNBs in CC. The elements of intraoperative staging of the disease and pathological cancer features were compared with accuracy, sensitivity and false negative results of SNB in CC by means of ROC curves and the tests for population proportions.
Results:
ROC curve analysis did not reveal any statistical significance for tumour measurements (all p > 0.05). Statistically significantly worse results in sensitivity (not in accuracy) were achieved for T3 tumours in comparison with T2 tumours (83% vs 89%, p = 0.0066). Statistically significantly worse results in accuracy (not in sensitivity) of the method were obtained in the cases of involved lymph nodes (78% vs 100%, p < 0.0001), infiltration of the lymph node capsule (80% vs 97%, p = 0.0023) and infiltration of the perinodal tissue (73% vs 97%, p = 0.0002). The analyses of SNB sensitivity and accuracy in combination with other features showed no statistical significance (all p > 0.05).
Conclusions:
The sensitivity of the method is significantly worse for tumours with deeper infiltration of intestinal wall. The presence of nodal metastases, lymph node capsule and perinodal invasion significantly affects the accuracy results of SNB in CC. The problem of qualifying patients for the procedure in regard to the other analysed features, however, remains open and requires further analysis.
