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2004, Number 1

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Cir Gen 2004; 26 (1)

Lymphatic mapping and sentinel node biopsy in gastrointestinal neoplasms

Flores AJ, Cushieri A, Varela G

Language: English
References: 35
Page: 23-28
PDF size: 67.92 Kb.


ABSTRACT

Objective. To discuss whether available information supports lymphatic mapping and sentinel node histology as a useful tool to grade gastrointestinal (GI) malignancies.
Data collection. Selective review of the literature. (Thirty-five references)
Data sellection. The most relevant paper dealing with lymphatic mapping and sentinel node biopsy were selected.
Setting: Third healt care level hospital
Results. The use of lymphatic mapping and sentinel node biopsy has been validated in melanoma and breast cancer. Recently, this staging scheme has been implemented for other solid tumors including neoplasms of the gastrointestinal (GI) tract. Lymph node mapping has two salutary advantages: reduction of morbidity associated with the use of conventional staging lymphadenectomy, while staging accuracy remains unaffected. Early experience with lymphatic mapping for neoplasms of the GI tract, following the introduction of the sentinel lymph node concept, indicates that this approach is feasible and, like in breast cancer and melanoma, can also identify micrometastatic malignancies of the GI tract. Reported series have shown identification rates ranging between 85% and 97%. These numbers are higher than the preliminary reports for melanoma and breast cancer. However, the biological implication of micrometastases remains debatable and further studies/evaluation about the role of lymph node mapping based on sentinel biopsy for GI neoplasms is required.
Conclusion. Current information indicates that lymphatic mapping and sentinel node biopsy have the potential to identify important nodes in the region of a tumor. Furthermore, the focused analysis of harvested sentinel nodes can improve tumor staging.


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