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Sentinel Lymph Node Mapping in Colon and Rectal Cancer

Its Impact on Staging, Limitations, and Pitfalls

  • Chapter
Selective Sentinel Lymphadenectomy for Human Solid Cancer

Part of the book series: Cancer Treatment and Research ((CTAR,volume 127))

Abstract

Sentinel lymph node (SLN) mapping has been widely applied in the staging of solid neoplasms including colon and rectal cancer. Since the first reported feasibility study in 1997, there have been numerous publications validating SLN mapping as a highly accurate and powerful upstaging technique for colon and rectal cancer. In addition to refining the technical aspects of this procedure, these studies have investigated the use of other tracers and operative techniques, while determining the indications, limitations, and pitfalls of SLN mapping in patients with colorectal cancers. This chapter reviews the rationale for performing SLN mapping for the accurate staging of colon and rectal cancers, and provides a brief review of the historical background of the development of the procedure. Landmark publications, which have contributed to the current status of the technique, are discussed. We will focus on the technical details of the procedure, and on the pathological evaluation of the specimen and the SLNs. The various tracers and techniques of SLN mapping in colon and rectal cancer will be discussed. We have performed SLN mapping in more than 240 consecutive patients over the past 7 years. The success rates for identifying at least one SLN for colon and rectal cancer were 100% and 90.6%, respectively. The accuracy rates were 95.8% and 100%, respectively. In terms of upstaging, 32.3% of colon cancer patients with nodal metastases and 16.7% of rectal patients with nodal metastases were upstaged by the detection of micrometastases found in the SLNs only. Finally, we will also discuss the current role as well as the future research directions for SLN mapping in colon and rectal cancer.

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Author information

Authors and Affiliations

  1. Michigan State University, Flint, Michigan

    Sukamal Saha, Adrian G. Dan & David Wiese

  2. University of Basel, Switzerland

    Carsten T. Viehl

  3. Kantonsspital Olten, Olten, Switzerland

    Markus Zuber

Authors
  1. Sukamal Saha
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  2. Adrian G. Dan
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  3. Carsten T. Viehl
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  4. Markus Zuber
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  5. David Wiese
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Editor information

Editors and Affiliations

  1. Department of Surgery, University of California, Medical Center at Mount Zion, 1600 Divisadero Street, San Francisco, CA, 94143

    Stanley P. L. Leong

  2. Department of Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yuko Kitagawa  & Masaki Kitajima  & 

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Saha, S., Dan, A.G., Viehl, C.T., Zuber, M., Wiese, D. (2005). Sentinel Lymph Node Mapping in Colon and Rectal Cancer. In: Leong, S.P.L., Kitagawa, Y., Kitajima, M. (eds) Selective Sentinel Lymphadenectomy for Human Solid Cancer. Cancer Treatment and Research, vol 127. Springer, Boston, MA. https://doi.org/10.1007/0-387-23604-X_5

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  • DOI: https://doi.org/10.1007/0-387-23604-X_5

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-23603-2

  • Online ISBN: 978-0-387-23604-9

  • eBook Packages: MedicineMedicine (R0)

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