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Sentinel Lymph Node Detection in Colorectal Cancer - First Experience.

Sinisa Stojanoski1, Nevena Manevska1, Svetozar Antovic2

  • 1Institute for Pathophysiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.

Open Access Macedonian Journal of Medical Sciences
|November 11, 2017
PubMed
Summary

Sentinel lymph node (SLN) detection using radiocolloid is effective in colorectal cancer (CRC) patients. This method reliably identifies SLNs, aiding in accurate staging and treatment selection for CRC.

Keywords:
colorectal cancerlymphoscintigraphymetastasisradiocolloidsentinel lymph node

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Surgical Pathology

Background:

  • Colorectal cancer (CRC) is a leading cause of cancer death globally.
  • Lymph node (LN) status is critical for CRC prognosis and staging.
  • Accurate staging is essential for effective CRC treatment protocols.

Purpose of the Study:

  • To evaluate the efficacy of radiocolloid for sentinel lymph node (SLN) detection in colorectal cancer (CRC).
  • To assess the detection rate, sensitivity, accuracy, and negative predictive value of the SLN method.
  • To determine the potential for upstaging CRC patients using SLN analysis.

Main Methods:

  • The study involved 40 CRC patients with no detectable lymph nodes on CT/MRI.
  • Sentinel lymph nodes (SLNs) were identified using endoscopically injected 99mTc-SENTISCINT radiocolloid.
  • Ex vivo detection of SLNs followed by comprehensive pathohistological analysis of all resected lymph nodes.

Main Results:

  • The SLN identification rate was 95%.
  • The procedure demonstrated high accuracy (92.1%) and a negative predictive value of 86.95%.
  • Sensitivity was 83.3%, with a significant upstage rate of 22.5%.

Conclusions:

  • Radiocolloid-based SLN detection is a feasible and reliable method in CRC patients.
  • The established detection rates and diagnostic values support its clinical utility.
  • This technique is expected to improve staging for Stage II CRC patients, optimizing treatment selection.