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Simplified intraoperative sentinel-node detection performed by the urologist accurately determines lymph-node stage in prostate cancer
Lund Univ, Vaxjo Hosp, Dept Surg, S-22100 Lund, Sweden..ORCID iD: 0000-0001-6441-4729
Lund Univ, Helsingborg Hosp, Dept Urol, S-22100 Lund, Sweden..
Lund Univ, Skane Univ Hosp, Dept Urol, S-22100 Lund, Sweden..
Orebro University Hospital. Department of Urology.
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2015 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 49, no 2, 97-102 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The reference standard for lymph-node staging in prostate cancer is currently an extended pelvic lymph-node dissection (ePLND), which detects most, but not all, regional lymph-node metastases. As an alternative to ePLND, sentinel-node dissection with preoperative isotope injection and imaging has been reported. The objective was to determine whether intraoperative sentinel-node detection with a simplified protocol can accurately determine lymph-node stage in prostate cancer patients.

Materials and methods: Patients with biopsy-verified high-risk prostate cancer with tumour stage T2-3 were included in the study. All patients underwent both ePLND and sentinel-node detection. Tc-99m-marked nanocolloid was injected peritumourally by the operating urologist after induction of anaesthesia just before surgery. Sentinel nodes were detected both in vivo and ex vivo intraoperatively using a gamma probe. Sentinel nodes and metastases and their locations were recorded. Sensitivity and specificity were calculated.

Results: At least one sentinel node was detected in 72 (87%) of the 83 patients. In 13 (18%) of these 72 patients sentinel nodes were detected outside the ePLND template. In six of these 13 patients, the Sentinel nodes from outside the template contained metastases, which proved to be the only metastases in two. For 12 patients the only metastatic deposit found was a micrometastasis (<= 2 mm) in a sentinel node. In the 72 patients with detectable sentinel nodes, pathological analysis of the sentinel node correctly categorized 71 and ePLND 70 patients.

Conclusions: This protocol yielded results comparable to the commonly used technique of sentinel-node detection, but with more cases of non-detection.

Place, publisher, year, edition, pages
Informa Healthcare, 2015. Vol. 49, no 2, 97-102 p.
Keyword [en]
Extended serial sectioning, immunohistochemistry, lymph-node staging, prostate cancer, sentinel lymph-node biopsy, sentinel node
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:oru:diva-56523DOI: 10.3109/21681805.2014.968867ISI: 000351395600003PubMedID: 25331366Scopus ID: 2-s2.0-84924937614OAI: oai:DiVA.org:oru-56523DiVA: diva2:1082638
Funder
Swedish Cancer Society, 2012/475
Note

Funding Agencies:

FoU Kronoberg

Cancerstiftelsen Kronoberg

Available from: 2017-03-17 Created: 2017-03-17 Last updated: 2017-03-17Bibliographically approved

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Kjolhede, HenrikSundqvist, Pernilla
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