Intraoperative sentinel lymph node mapping in patients with colon cancer

Background: The sentinel lymph node (SLN) mapping technique has been used i n breast cancer and melanoma, and was recently described for colon cancer. Methods: Thirty-five patients with colon cancer underwent intraoperative SL N mapping. One milliliter of 1% isosulfan blue was injected subserosally ar ound the tumor. The first nodal area that was highlighted with blue was ide ntified as the SLN. All lymph nodes underwent examination with hematoxylin and eosin (H&E) stain. SLNs underwent additional sectioning and were staine d with CAM 5.2. Results: Lymphatic mapping adequately identified the SLN in 25 patients (71 %). In the 15 cases where the SLNs were negative for metastases, all other non-SLNs were also negative (0% false negative rate). The SLN was the only site of metastases in 6 (17%) of 35 patients. CAM 5.2 staining provided the only evidence of micrometastases in 4 (11%) of 35 patients. Conclusions: Intraoperative SLN mapping is a feasible technique with a reas onable SLN identification rate (71%). The absence of metastases in the SLNs accurately predicts the status of the non-SLNs. Tumors in 11% of patients were upstaged by the demonstration of micrometastatic involvement, and thes e patients may benefit from further adjuvant chemotherapy. (C) 2001 Excerpt a Medica, Inc. All rights reserved.