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Sentinel Node Procedure (sentinel + node_procedure)

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Medical Sciences100%

Selected Abstracts

Clinical relevance of parasternal uptake in sentinel node procedure for breast cancer

JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2004
Hans F.J. Fabry MD
Abstract Background and Objectives Preoperative lymphoscintigraphy contributes highly to the accuracy of the sentinel node procedure. Besides routing towards the axilla, in a number of patients additional parasternal focal accumulation may be observed. So far the clinical consequences of this parasternal uptake remains unclarified, i.e., whether any internal mammary lymph node uptake should be surgically biopsied. An analysis of all sentinel node procedures with parasternal uptake was performed. Methods Sixty-nine patients with scintigraphic parasternal uptake and with a minimal follow-up of 24 months, were selected from a prospective database. Tumor characteristics, treatment strategies, and recurrences of these patients were analyzed and subsequently matched against the present day indications for adjuvant treatment. Results During follow-up (median 41 months) only four (6%) patients developed systemic disease. Initially, three of these patients did not receive adjuvant chemotherapy. Two are alive without evidence of disease after treatment of these recurrences. Currently these patients would, initially, all have been eligible for chemotherapy based on tumor characteristics and age according to international guidelines. Conclusions For the indication of adjuvant treatment, the status of the internal mammary lymph nodes was not relevant in our patients. Parasternal uptake is not an indication to extend the surgical procedure. J. Surg. Oncol. 2004;87:13,18. © 2004 Wiley-Liss, Inc. [source]

Repeat dynamic sentinel node biopsy in locally recurrent penile carcinoma

BJU INTERNATIONAL, Issue 8 2010
Niels M. Graafland
Study Type , Diagnosis (case series) Level of Evidence 4 OBJECTIVE To explore the role of repeat dynamic sentinel-node biopsy (SNB) in clinically node-negative patients with locally recurrent penile carcinoma after previous penile surgery and SNB. PATIENTS AND METHODS Between 1994 and 2008, 12 patients (4% of the 304 in our prospectively maintained dynamic sentinel node database) with clinically node-negative groins had a repeat SNB for locally recurrent penile carcinoma after previous penile surgery and SNB. Five of these patients had previously had a unilateral inguinal node dissection for groin metastases. The median disease-free interval was 18 months. The protocol and technique of primary dynamic SNB and the repeat procedure were similar, including preoperative lymphoscintigraphy and blue-dye injection. Completion inguinal node dissection was only done if there was an involved sentinel node. RESULTS No sentinel nodes were seen on preoperative lymphoscintigraphy in the five groins that had previously been dissected. A sentinel node was visualized on lymphoscintigraphy in the remaining 19 undissected groins. In 15 of these groins (79%) the sentinel node was identified during surgery. Histopathological analysis showed involved sentinel nodes in four groins of three patients. Additional metastatic nodes were found in one completion inguinal lymph node dissection specimen. During a median follow-up of 32 months after the repeat SNB, one patient developed a groin recurrence 14 months after a tumour-negative sentinel node procedure. CONCLUSIONS Repeat dynamic SNB is feasible in clinically node-negative patients with locally recurrent penile carcinoma despite previous SNB. [source]

Clinical relevance of parasternal uptake in sentinel node procedure for breast cancer

JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2004
Hans F.J. Fabry MD
Abstract Background and Objectives Preoperative lymphoscintigraphy contributes highly to the accuracy of the sentinel node procedure. Besides routing towards the axilla, in a number of patients additional parasternal focal accumulation may be observed. So far the clinical consequences of this parasternal uptake remains unclarified, i.e., whether any internal mammary lymph node uptake should be surgically biopsied. An analysis of all sentinel node procedures with parasternal uptake was performed. Methods Sixty-nine patients with scintigraphic parasternal uptake and with a minimal follow-up of 24 months, were selected from a prospective database. Tumor characteristics, treatment strategies, and recurrences of these patients were analyzed and subsequently matched against the present day indications for adjuvant treatment. Results During follow-up (median 41 months) only four (6%) patients developed systemic disease. Initially, three of these patients did not receive adjuvant chemotherapy. Two are alive without evidence of disease after treatment of these recurrences. Currently these patients would, initially, all have been eligible for chemotherapy based on tumor characteristics and age according to international guidelines. Conclusions For the indication of adjuvant treatment, the status of the internal mammary lymph nodes was not relevant in our patients. Parasternal uptake is not an indication to extend the surgical procedure. J. Surg. Oncol. 2004;87:13,18. © 2004 Wiley-Liss, Inc. [source]