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01.09.2009 | Original Article | Ausgabe 9/2009

European Journal of Nuclear Medicine and Molecular Imaging 9/2009

Validation of sentinel lymph node dissection in prostate cancer: experience in more than 2,000 patients

Zeitschrift:
European Journal of Nuclear Medicine and Molecular Imaging > Ausgabe 9/2009
Autoren:
G. Holl, R. Dorn, H. Wengenmair, D. Weckermann, J. Sciuk

Abstract

Purpose

Sentinel lymph node dissection (SLND) has replaced extended lymphadenectomy for nodal staging in several solid tumours. We present our results of SLND in prostate cancer in regard to detection and false-negative rate.

Methods

In a 2-day protocol about 300 MBq 99mTc-nanocolloid are injected into the prostate. Two hours later static scans of the pelvis are performed to get information about the number and location of radioactive lymph nodes. During surgery the radioactive nodes are excised with the help of a gamma probe and sent separately to the pathologist. The histological procedure includes haematoxylin and eosin staining, serial sections and immunohistochemistry.

Results

Since 1999, a total of 2,020 men underwent SLND alone or in combination with either standard or extended lymphadenectomy after radical retropubic prostatectomy. Lymph nodes positive for metastases were found in 16.7% of patients. The scintigraphic detection rate was 97.6% and the intraoperative detection rate 98%. For 187 lymph node-positive men who had either standard or extended lymphadenectomy in addition to SLND the false-negative rate could be calculated, resulting in false-negative findings in 11 of 187 patients (6%).

Conclusion

Our results demonstrate that SLND in prostate cancer is a reliable procedure for nodal staging.

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