Sentinel node identification using technetium-99m neomannosyl human serum albumin in esophageal cancer.

Abstract

BACKGROUND:

This study is a clinical trial designed to test the reliability and feasibility of sentinel node detection using a new mannose receptor radioactive binding agent in patients with esophageal squamous cell carcinoma.

METHODS:

Twenty-three patients (21 men, 2 women; mean age 61.0±8.60 years) who were candidates for esophagectomy with conventional lymph node dissection for thoracic esophageal cancer were enrolled. A total dose of 1 mCi of 99mTc-MSA [technetium-99m neomannosyl human serum albumin] in 0.2 mL was administered at 4 quadrants into the submucosal layer around the primary tumor under esophagoscopic guidance approximately 1 hour before surgery. Intraoperative sentinel node sampling was subsequently followed by esophagectomy. All harvested lymph nodes were cut into 2-mm slices and ultimately diagnosed using formalin-fixed and paraffin-embedded sections with hematoxylin and eosin staining.

RESULTS:

The number of dissected lymph nodes per patient was 30.5±9.18 (15-47). Among 23 patients, the sentinel lymph nodes could be identified in 21 patients (91.3%). The sentinel nodes could be identified in all 21 patients with cT1 or T2N0M0 (100%) disease; these patients were candidates for sentinel lymph node navigation surgery for the esophageal cancer. The mean number of sentinel nodes identified was 2.6±1.35 (range, 1-5) per patient. No false-negative sentinel lymph nodes were detected in any of the 8 patients with node-positive disease (0%).

CONCLUSIONS:

Intraoperative sentinel lymph node identification using 99mTc-MSA was feasible and reliable in patients with esophageal squamous cell carcinoma.

• Authors: Hyun Koo Kim, SeungEun Kim, Jong Jae Park, Jae Min Jeong, Young Jae Mok, Young Ho Choi
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 91 Issue 5 Pg. 1517-22 (May 2011) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 21377648 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Technetium Tc 99m Aggregated Albumin

Topics

• Aged
• Carcinoma, Squamous Cell (diagnostic imaging, mortality, pathology, surgery)
• Esophageal Neoplasms (diagnostic imaging, mortality, pathology, surgery)
• Esophagectomy (methods, mortality)
• False Negative Reactions
• Female
• Follow-Up Studies
• Humans
• Injections, Intravenous
• Lymph Nodes (diagnostic imaging, pathology, surgery)
• Male
• Middle Aged
• Monitoring, Intraoperative (methods)
• Neoplasm Staging
• Preoperative Care (methods)
• Prospective Studies
• Radionuclide Imaging
• Reproducibility of Results
• Risk Assessment
• Sensitivity and Specificity
• Sentinel Lymph Node Biopsy (methods)
• Survival Analysis
• Technetium Tc 99m Aggregated Albumin
• Treatment Outcome