Klin Onkol 2006; 19(6): 305-309.
Summary
Background: The method of detection and removal of the sentinel lymph node (SLN) is a current challenge in many kinds of solid malignancies. This paper discusses experience in identification and obtaining of SLN in tumors of the distal esophagus and the gastric cardia.
Design and Subjects: A prospective nonrandomized study was performed in 38 patients with esophageal cancer before neoadjuvant therapy.
Methods and Results: SLN was detected in 22 cases employing patent blue. In 2 cases only a radionuclide was used and in 14 patients a combination of both methods was applied. SLN was found, after endoscopic application of the detection substance, via laparoscopic trans-hiatal approach. SLN were examined histopathologically and also immunohistochemically. SLN was successfully detected in 19 patients. Metastatic involvement was found in 10 patients, micrometastatic involvement in 2 patients. Remaining patients showed no involvement of SLN. Results of examination of SLN were compared to results of standard lymphadenectomy, performed during subsequent routine D2 lymphadenectomy. False negativity of SLN was revealed in one case.
Conclusions: The study proved a clinical usability of the method in esophageal cancer. Its clinical significance is especially in a possible less-invasive treatment, mainly in initial stages of the disease.
