Accuracy of Sentinel Lymph Node Mapping in Laparoscopic Surgery for Colorectal Cancer
Abstract
Background and Objective: The metastatic status of regional lymph nodes is a major prognostic factor in
colorectal cancer and is important for determining adjuvant therapy. The objective of the present study was to
determine the accuracy of sentinel lymph node (SLN) mapping in cases of cancer of the colon, compared to the
regional lymph node status.
Methods: From March 2010 - November 2011, colon cancer patients without distant metastasis were invited
to participate in this study. Participants underwent either laparoscopic assisted or a hand assisted laparoscopic colon
resection. Isosulfan blue dye was injected at the subserosal and peritumoral sites. After the identification of SLN,
a standard colectomy was done. All lymph nodes were stained by hematoxylin and eosin, and multiple sections of each
SLN were examined by immunohistochemical (IHC) staining using a cytokeratin antibody.
Results: The SLN was identified laparoscopically in all patients. One patient (9 %) was SLN positive. There
were three false-negative SLNB results (75 %). The SLN accurately predicted the tumor status of the nodal basin in
72 % of the cases, and the negative predictive value was 70 %.
Conclusion: This preliminary report demonstrated the low accuracy of SLN mapping (72 %) and the high false
negative rate (75 %) in laparoscopic colon cancer procedures. Large prospective studies should be performed to
determine the true accuracy and false-negative rate of the technique.
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