Feasibility of sentinel node detection in renal cell carcinoma: a pilot study

@article{Bex2009FeasibilityOS,
  title={Feasibility of sentinel node detection in renal cell carcinoma: a pilot study},
  author={Axel Bex and Lenka Vermeeren and Geraldine de Windt and Warner Prevoo and Simon Horenblas and Renato A. Vald{\'e}s Olmos},
  journal={European Journal of Nuclear Medicine and Molecular Imaging},
  year={2009},
  volume={37},
  pages={1117-1123}
}
  • A. Bex, L. Vermeeren, R. Olmos
  • Published 29 January 2010
  • Medicine
  • European Journal of Nuclear Medicine and Molecular Imaging
PurposeLymphatic drainage from renal cell carcinoma is unpredictable and the therapeutic benefit and extent of lymph node dissection are controversial. We evaluated the feasibility of intratumoural injection of a radiolabelled tracer to image and sample draining lymph nodes in clinically non-metastatic renal cell carcinoma.MethodsEight patients with cT1–2 cN0 cM0 (<6 cm) renal cell carcinoma prospectively received percutaneous intratumoural injections of 99mTc-nanocolloid under ultrasound… 

Lymphatic Drainage from Renal Cell Carcinoma along the Thoracic Duct Visualized with SPECT/CT

TLDR
Of 42 patients, 4 showed early lymphatic drainage following the course of the thoracic duct on lymphoscintigraphy and SPECT/CT images, and in one patient, this was observed without any retroperitoneal lymph node interposition.

Lymphatic drainage from renal cell carcinoma along the thoracic duct visualized with SPECT/CT.

TLDR
Direct aberrant drainage through the thoracic duct can be observed in vivo as demonstrated in this study and may support a hypothesis for certain anatomical metastatic sites and the failure to demonstrate a survival benefit of retroperitoneal lymph node dissections in renal cell carcinoma.

An analysis of SPECT/CT non-visualization of sentinel lymph nodes in renal tumors

TLDR
It is demonstrated that non-visualization of SNs in renal tumors is relatively high and is associated with patient age, which limits the use of SLNB for research and clinical purposes in renal cancer.

Outcome of sentinel lymph node biopsy in patients with clinically non-metastatic renal cell carcinoma

TLDR
The rate of occult metastatic SN is low, but long disease-free survival (DFS) was observed in two patients with occult SN metastases and an interaortocaval lymphatic route in thoracic recurrences is hypothesize.

Challenging Visualization of Sentinel Lymph Nodes in Upper Urinary Tract Urothelial Carcinoma

TLDR
It is demonstrated that detection of SLNs in the upper urinary tract is possible yet challenging and SPECT/CT lymphangiography in cases of UTUC may provide valuable information about a patient’s individual anatomy of the lymphatic system and the position of the first lymph nodes draining lymph with potential metastatic cells from the tumor.

Role of Lymphadenectomy in Renal Cell Cancer

TLDR
In this chapter, the available evidence is summarized, and implications on clinical practice of lymph node staging in RCC are discussed.

Role of Lymphadenectomy

TLDR
In my opinion there is no reason today not to do an easy LND in all RCC patients who could have microscopic nodal disease and not only in high-risk patients, and certainly in the actually selected RN candidates.

Lymph node dissection in renal cell carcinoma.

References

SHOWING 1-10 OF 29 REFERENCES

Intraoperative mapping of renal lymphatic drainage: technique and application in a porcine model.

TLDR
Sentinel lymph node sampling using a gamma probe and blue dye appears to be feasible in the porcine kidney, and the impact of selective lymphadenectomy on survival in RCC is evaluated.

Lymphatic mapping in patients with breast carcinoma: reproducibility of lymphoscintigraphic results.

TLDR
Results of lymphoscintigraphy for lymphatic mapping in breast cancer are highly reproducible for assessment of the number of sentinel nodes.

Renal cell carcinoma with retroperitoneal lymph nodes: role of lymph node dissection.

TLDR
Regional lymph node dissection is unnecessary in patients with clinically negative lymph nodes since it offers extremely limited staging information and no benefit in terms of decreasing disease recurrence or improving survival.

Evaluation of mammary lymphoscintigraphy by a single intratumoral injection for sentinel node identification.

TLDR
M mammary lymphoscintigraphy by single intratumoral injection is a valid method for lymphatic mapping and identification of both axillary and nonaxillary sentinel nodes andymph node visualization appears to be improved with higher tracer doses.

Lymphatogenous spread of renal cell carcinoma: an autopsy study.

Value of SPECT/CT for Detection and Anatomic Localization of Sentinel Lymph Nodes Before Laparoscopic Sentinel Node Lymphadenectomy in Prostate Carcinoma

TLDR
More sentinel nodes can be detected with SPECT/CT than with planar imaging alone, and the modality provides useful additional information about the anatomic location of sentel nodes within and outside the pelvic area, leading to improved intraoperative sentinel node identification.

Clinical significance of lymph node dissection in renal cell carcinoma

TLDR
Tumor size is a crucial prognostic factor for tumor progression, and lymph node dissection may be omitted in T1a tumors, according to a Cox hazard model.

The Yield of SPECT/CT for Anatomical Lymphatic Mapping in Patients with Melanoma

TLDR
SPECT/CT detects additional drainage and shows the exact anatomical location of sentinel nodes in patients with inconclusive conventional lymphoscintigrams and facilitates surgical exploration in difficult cases and may improve staging.

Technical details of intraoperative lymphatic mapping for early stage melanoma.

TLDR
Patients with early stage melanoma who have nodal metastases and are likely to benefit from radical lymphadenectomy are identified, with a high degree of accuracy, by a new procedure developed using vital dyes.

[Tumor size and regional lymph node metastasis in patients with M0 renal cell carcinoma: analysis in those having regional lymph node dissection].

TLDR
Although the role of regional lymph node dissection with radical nephrectomy might be limited and controversial in renal cell carcinoma, urological surgeons should always be aware of possible metastasis for any tumor size.