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Sentinel lymph node in cervical cancer

Ju-Hyun Kim, Dae-Yeon Kim, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
BACKGROUND: Lymph node metastasis is a significant predictive factor for disease recurrence and survival in cervical cancer patients. Given the importance of lymph node metastasis, it is imperative that patients harboring metastasis are identified and can undergo appropriate treatment. Sentinel lymph node (SLN) mapping has drawn attention as a lymph node mapping technique. We evaluated the feasibility and efficacy of (SLN) mapping using indocyanine green (ICG) in cervical cancer. METHODS: We performed a single-center, retrospective study of 103 surgically treated cervical cancer patients who underwent SLN mapping...
March 9, 2018: World Journal of Surgical Oncology
Yue Yang, Benqing Zhou, Jian Zhou, Xiangyang Shi, Yan Sha, Haitao Wu
OBJECTIVE: To evaluate the capability of indirect computed tomography and magnetic resonance lymphography (CT/MR-LG) with gadolinium-loaded, polyethylenimine-entrapped gold nanoprobes (Gd-Au PENPs) for assessing lingual sentinel lymph node (SLN) metastasis in a tongue VX2 carcinoma model. MATERIALS AND METHODS: Seventeen rabbits were used to establish a metastatic cervical lymph node model by implanting VX2 carcinoma suspension into the ventral tongue muscle. CT and MR images were acquired one hour after Gd-Au PENPs injection into the tongue submucosa bilaterally, on 1w (n = 4), 2w (n = 6) and 3w (n = 7) tumour-bearing rabbits after carcinoma transplantation...
March 7, 2018: Acta Oto-laryngologica
Mikel Gorostidi, Cecilia Villalain, Ruben Ruiz, Ibon Jaunarena, Arantxa Lekuona, Irene Diez
STUDY OBJECTIVE: To determine the importance of a dual (cervical and fundal) indocyanine green (ICG) injection and a thorough dissection for the detection of sentinel lymph node (SLN). DESIGN: Step-by-step description of a surgical procedure using video (Canadian Task Force III) SETTING: Hospital Universitario Donostia (Spain). PATIENTS: A 60-year-old woman with a diagnosis of IAG1 endometrial adenocarcinoma (EC). INTERVENTIONS: The patient underwent a cervical and transcervical fundal ICG injection for paraortic and pelvic SLN detection in the setting of a research protocol and a total hysterectomy and bilateral salpingo-oophorectomy with frozen section of the uterus as standard approach (1)...
March 1, 2018: Journal of Minimally Invasive Gynecology
Yuji Kumakura, Takehiko Yokobori, Tomonori Yoshida, Keigo Hara, Makoto Sakai, Makoto Sohda, Tatsuya Miyazaki, Hideaki Yokoo, Tadashi Handa, Tetsunari Oyama, Hiroshi Yorifuji, Hiroyuki Kuwano
BACKGROUND: Lymph node metastasis (LNM) is a standard mechanism of cancer progression in esophageal squamous cell carcinoma (ESCC). We aimed to clarify the anatomical mechanism of skip nodal metastasis to mediastinal zones by analyzing the relationship between LNM to sentinel zones and lymphatic vessel counts in the muscle layer adjacent to the outer esophagus. METHODS: We examined the surgical records of 287 patients with ESCC who underwent potentially curative surgery (three-field lymphadenectomy) and whole esophagi, including pharynges and stomachs from 10 cadavers, to determine the number of lymphatic vessels in the intra-outer longitudinal muscle layer adjacent to the outer esophagus of the cervical (Ce), upper thoracic, middle thoracic (Mt), lower thoracic (Lt), and abdominal esophagi (Ae)...
February 23, 2018: Annals of Surgical Oncology
Salih Taşkin, Duygu Altin, Yavuz Emre Şükür, Firat Ortaç
OBJECTIVE: The aim of the study was to evaluate extrapelvic sentinel lymph nodes (SLNs) in clinical early-stage endometrial cancer patients with unmapped pelvic side(s) during fluorescent imaging-based sentinel mapping. MATERIALS AND METHODS: Eligible patients underwent sentinel mapping using cervical injection of indocyanine green and near-infrared florescent imaging compatible endoscopic systems. Pelvic SLNs were identified and resected. If bilateral mapping was not achieved, upper lymph nodes areas including presacral, upper common iliac, and para-aortic caval regions were explored for any SLN...
February 22, 2018: International Journal of Gynecological Cancer
Dong Hoon Suh, Miseon Kim, Kyung Hun Lee, Keun Yong Eom, Maj Kamille Kjeldsen, Mansoor Raza Mirza, Jae Weon Kim
In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer...
March 2018: Journal of Gynecologic Oncology
Daniel Vázquez-Vicente, Bárbara Fernández Del Bas, José García Villayzán, Javier Plaza Arranz, Luis Chiva
STUDY OBJECTIVE: The objective was to review/learn a surgical technique not very well known by gynecologic oncologists. DESIGN: Level of evidence: III SETTING: Review of a surgical technique with emphasis on the paraaortic sentinel lymph nodes using indocyanine green. INTERVENTION: The film features the following steps to perform the procedure: 1. Creating a retroperitoneal window. 2. What to do if the peritoneum is torn. 3. Finding the psoas muscle, right ureter, and common iliac artery...
February 7, 2018: Journal of Minimally Invasive Gynecology
Shinichi Togami, Toshihiko Kawamura, Mika Fukuda, Shintaro Yanazume, Masaki Kamio, Hiroaki Kobayashi
BACKGROUND: The standard surgical procedure for early-stage cervical cancer is abdominal radical hysterectomy, including pelvic lymphadenectomy. Currently, minimally invasive surgical techniques for early cervical cancer are progressing; total laparoscopic radical hysterectomy (TLRH) is a possible alternative to abdominal surgery. In addition, sentinel node navigation surgery (SNNS), which can prevent lower limb edema, has been widely used for radical hysterectomy. MATERIALS AND METHODS: A radioisotope is injected into the uterine cervix 1 day preoperatively and surgeons carefully identify the correct sentinel lymph nodes (SLNs) to prevent picking up the cervical gamma rays during surgery...
January 10, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Barbara Geppert, Céline Lönnerfors, Michele Bollino, Jan Persson
OBJECTIVE: To compare the rate of lymphatic complications in women with endometrial cancer undergoing sentinel lymph node biopsy versus a full pelvic and infrarenal paraaortic lymphadenectomy, and to examine the overall feasibility and safety of the former. METHODS: A prospective study of 188 patients with endometrial cancer planned for robotic surgery. Indocyanine green was used to identify the sentinel lymph nodes. In low-risk patients the lymphadenectomy was restricted to removal of sentinel lymph nodes whereas in high-risk patients also a full lymphadenectomy was performed...
March 2018: Gynecologic Oncology
Nicolò Bizzarri, Valentina Ghirardi, Ali Kucukmetin
OBJECTIVES: The standard treatment for FIGO stage 1B1 cervical cancer is radical hysterectomy (RH) [1]. Indocyanine-green (ICG) is a drug injected within the cervical stroma to detect the sentinel lymph node (SLN) in cervical cancer [2,3]. ICG travels through the lymphatic channels in the lateral parametrium, which results enhanced with green, before reaching the SLNs. This could help identifying the surgical landmarks. The aim of this video is to propose a new approach to perform parametrial dissection as part of RH under the guidance of ICG...
February 2018: Gynecologic Oncology
Young Min Park, Yu Hua Quan, Ki Hyeok Kwon, Jae-Gu Cho, Jeong-Soo Woo, Beop-Min Kim, Yun-Sang Lee, Jae Min Jeong, Hyun Koo Kim, Jae-Jun Song
OBJECTIVE: The aim of this study was to determine the possibility of endoscopic sentinel lymph node biopsy of the head and neck region using indocyanine green-neomannosyl human serum albumin (ICG:MSA) and a custom-made intraoperative color-and-fluorescence-merged imaging system (ICFIS). METHODS: Using mouse and rabbit models of tongue cancer, we performed sentinel lymph node biopsy using an ICG:MSA tracer and custom imaging system equipped with an endoscope. RESULTS: ICG:MSA was localized to the cervical lymph node on the ipsilateral side for up to 30 minutes compared to ICG tracer (ICG n = 3, IGC:MSA n = 3)...
December 7, 2017: Laryngoscope
Stefano Restaino, Carlo Ronsini, Angelo Finelli, Emanuele Perrone, Giovanni Scambia, Francesco Fanfani
Background: Sentinel Lymphonode analysis has become a barely new and innovative way to treat early stages of endometrial cancer (Ballester et al., Lancet Oncol 469-476, 2011; Buda et al., Ann Surg Oncol 2975-81, 2016). Indocyanine green cervical injection is considered gold standard for mapping nodes' drainage. Blue dye is used as a valid alternative in many centers, due to the lower cost of execution. The objective of this video is to prove that methylene blue dye's cervical injection is a valid and "low-cost" method to obtain mapping of lymphatic drainage in patient with early endometrial cancer...
2017: Gynecological Surgery
Ruben Ruiz, Mikel Gorostidi, Ibon Jaunarena, Constance Goiri, Justina Aguerre, Arantxa Lekuona
PURPOSE: The aim of this study was describe a novel sentinel lymph node (SLN) tracer injection procedure featuring dual cervical and fundal indocyanine green (ICG) injection for endometrial cancer and results of SLN biopsy. METHODS: Between June 26, 2014 and October 31, 2016, 111 patients underwent laparoscopic surgery for endometrial cancer at our institution. In all cases, we performed SLN biopsy with dual cervical and fundal ICG injection. All SLNs were processed with an ultrastaging technique...
January 2018: International Journal of Gynecological Cancer
Valtteri Häyry, Åsa Kågedal, Eric Hjalmarsson, Pedro Farrajota Neves da Silva, Cecilia Drakskog, Gregori Margolin, Susanna Kumlien Georén, Eva Munck-Wikland, Ola Winqvist, Lars Olaf Cardell
BACKGROUND: Detection of metastatic spread of head and neck cancer to cervical lymph nodes is essential for optimal design of therapy. Undetected metastases lead to mortality, which can be prevented by better detection methods. METHODS: We analysed 41 lymph nodes from 19 patients with oral squamous cell carcinoma (OSCC). Each lymph node was divided in two, one half processed for histopathology and the other half dissociated into single-cell suspension, stained for the carcinoma cell markers cytokeratin 5/8 (CK5/8), epithelial cell adhesion molecule (EpCAM) and epithelial mucin (MUC-1), and analysed with flow cytometry...
February 6, 2018: British Journal of Cancer
Kenzo Sonoda, Hideaki Yahata, Kaoru Okugawa, Eisuke Kaneki, Tatsuhiro Ohgami, Masafumi Yasunaga, Shingo Baba, Yoshinao Oda, Hiroshi Honda, Kiyoko Kato
BACKGROUND AND OBJECTIVES: Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis. METHODS: We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned...
November 15, 2017: Oncology
Henri Azaïs, Geoffroy Canlorbe, Yohan Kerbage, Anne Grabarz, Pierre Collinet, Serge Mordon
Image-guided surgery is a relevant way to reduce surgical morbidity and maximize cytoreductive surgery approach especially in ovarian cancer. Sentinel lymph node detection is a promising approach to avoid radical lymph node dissection and is slightly becoming standard in daily practice in endometrial and cervical cancer surgery even if it needs to be evaluated more precisely. Regarding carcinomatosis of ovarian origin, detection and treatment of microscopic disease could be appropriate to avoid local recurrences...
November 10, 2017: Future Oncology
Alessandro Buda, Andrea Papadia, Giampaolo Di Martino, Sara Imboden, Beatrice Bussi, Luca Guerra, Elena De Ponti, Claudio Reato, Maria Luisa Gasparri, Cinzia Crivellaro, Michael Mueller
STUDY OBJECTIVE: To evaluate the added value of the fluorescence dye indocyanine green (ICG) for sentinel lymph node (SLN) mapping in women with cervical cancer who had undergone previous conization (stage 1A-1B1) by comparing ICG versus Tc99m radiotracer + blue dye (BD). DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: Two European academic medical centers, San Gerardo Hospital, Italy and University of Berne, Switzerland...
October 12, 2017: Journal of Minimally Invasive Gynecology
Valeria M Moncayo, Adina L Alazraki, Naomi P Alazraki, John N Aarsvold
Accurate staging of many cancers with no clinical evidence of lymph node involvement is often a critical component of the management of such cancers and is generally and historically accomplished by accurate pathological assessment of multiple nodes. Unfortunately, such assessment usually involves excision of the multiple nodes and can result in significant morbidities. Over the past half century, and particularly over the last quarter century, investigators have defined and refined the "sentinel lymph node(s)" concept and have developed and investigated sentinel lymph node biopsy (SLNB) procedures...
November 2017: Seminars in Nuclear Medicine
S C Liang, Z Q Wang, J L Wang
Objective: To evaluate the feasibility and clinical value of identifying sentinel lymph node (SLN) and to assess possible factors associated with detection rate in both cervical cancer and endometrial cancer. Methods: Retrospective study of 76 cases (39 with cervical cancer and 37 with endometrial cancer) were conducted in Peking University People's Hospital. All patients underwent SLN biopsy with tracers of indocyanine green (ICG) and (or) carbon nanoparticles. All mapped SLN was resected and followed by procedures that systematic pelvic lymphadenectomy and hysterectomy according to National Comprehensive Cancer Network (NCCN) guidelines...
September 25, 2017: Zhonghua Fu Chan Ke za Zhi
Agata M Plonczak, Aimee N DiMarco, Roberto Dina, Dorothy M Gujral, Fausto F Palazzo
BACKGROUND: Metastases to the thyroid are rare. The most common primary cancer to metastasize to the thyroid is renal cell carcinoma, followed by malignancies of the gastrointestinal tract, lungs, and skin, with breast cancer metastases to the thyroid being rare. Overall, the outcomes in malignancies that have metastasized to the thyroid are poor. There are no prospective studies addressing the role of surgery in metastatic disease of the thyroid. Isolated thyroidectomy has been proposed as a local disease control option to palliate and prevent the potential morbidity of tumor extension related to the airway...
September 22, 2017: Journal of Medical Case Reports
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