Sentinel Node Mapping In Non-small Cell Lung Cancer By Radiotracer
reza bagheri, Sr.1, Ramin Sadeghi1, sousan shafiei1, Reza Basiri2.
1Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Ma, mashhad, Iran, Islamic Republic of, 2Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Ma, Mashhad, Iran, Islamic Republic of.
OBJECTIVE: Lymph node metastases are the most significant prognostic factor in localized non-small cell lung cancer (NSCLC). Identification of the first nodal drainage site may improve detection of metastatic nodes. Extended surgeries such as lobectomy or pneumonectomy with lymph node dissection are more acceptable for treatment. Sentinel node biopsy can be an alternative approach toward less invasive surgeries. In the current study we evaluated accuracy of sentinel node mapping in 21 patients with NSCLC by intra-operative radiotracer techniques.
METHODS: after thoracotomy, before mobilizing the tumor, peritumoral injection of 2mCi/0.4 mL Tc-99m- phytate was performed in tumor. After mobilization, the sentinel nodes were traced in hilar & mediastinal areas. Any lymph node with in vivo count twice the background was considered as sentinel node & sent for frozen section evaluation. All dissected nodes were evaluated by step sectioning, hematoxylin & eosin staining (H&E). The variables were age, sex, kind of pathology, site of lesion, number of dissected sentinel nodes, number of sentinel nodes & site of sentinel nodes.
RESULTS: 21 patients (male/female=15/ 6) were included in study with the age of 58.52±11.46 years. Most common site for tumor was left lower lobe (LLL) (30.09%). 11 patients had Squamous cell carcinoma (SCC) & 10 had Adeno carcinoma (AC). 120 lymph nodes were harvested with average of 5.71±2.9 lymph nodes per patient. at least one sentinel node could be identified in all patients (detection rate of 95.2 %). Mean number of sentinel nodes per patient was 3.61±2. Frozen section results showed 100% concordance with H&E results.
CONCLUSIONS: Sentinel node mapping can be considered feasible & accurate for lymph node staging & NSCLC treatment.
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