According to an article published in the Archives of Surgery, sentinel lymph node mapping during surgery allowed physicians to identify cancer spread to the lymph nodes in patients with early colorectal cancer. The results from the lymph node mapping were more accurate than those of standard procedures. This increased accuracy may allow for more individualized therapies.

Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. Cure rates are high for patients with colorectal cancer when disease is detected and treated prior to spread (early-stage cancer).

Patients with early-stage colorectal cancer often undergo scanning to determine if their cancer has spread to nearby lymph nodes. However, research continues into improving the accuracy of detecting microscopic spread of cancer cells to nearby lymph nodes.

Sentinel lymph node mapping is a technique performed during surgery. The surgeon injects dye near the site of the cancer; the dye then collects in the main, or sentinel, lymph nodes, which collect the first drainages from the cancer. The surgeon can remove the sentinel node(s), and the nodes are then reviewed by a pathologist to determine whether cancer cells are present. The sentinel node(s) are the most likely lymph node(s) to contain cancerous cells if the cancer has spread.

Patients with cancer spread to the nodes may gain more benefit from additional treatment with chemotherapy than patients whose cancer has not yet spread and may be completely removed with surgery alone.

Researchers from several institutions in the U.S. recently conducted a clinical trial to evaluate sentinel lymph node mapping among patients with early colorectal cancer. This trial included 111 patients who had been diagnosed with colorectal cancer and underwent surgery for their disease. Patients had also undergone standard screening procedures to detect cancer spread.

Cancer spread to the lymph nodes, which was not detected through standard screening, was found in 24% of patients through sentinel lymph node mapping.

The researchers concluded that the addition of sentinel lymph node mapping may provide valuable information regarding cancer spread to the lymph nodes in nearly one-quarter of patients with early colorectal cancer whose cancer spread is not detected through standard screening measures. Patients with early-stage colorectal cancer who are to undergo surgery for their disease may wish to speak with their physician regarding their individual risks and benefits of sentinel lymph node mapping. Patients may also wish to inquire about their surgeon’s experience in sentinel lymph node mapping.

Reference: Bilchik A, DiNome M, Saha S, et al. Prospective Multicenter Trial of Staging Adequacy in Colon Cancer. Archives of Surgery. 2006; 141: 527-534.

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