Initial experience in sentinel lymph node detection in pancreatic cancer

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• 作者：M. Beisani^a ; ^{mbeisani@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; I. Roca^b ; ^{isaroca@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; R. Cardenas^b ; L. Blanco^a ; M. Abu-Suboh^c ; J. Dot^c ; J.R. Armengol^c ; J.J. Olsina^d ; J. Balsells^a ; R. Charco^a ; J. Castell^b
• 关键词：Pancreatic cancer ; Sentinel node ; Lymphoscintigraphy
• 刊名：Revista Espa?ola de Medicina Nuclear e Imagen Molecular
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：35
• 期：5
• 页码：287-291
• 全文大小：1013 K

文摘

The local recurrence of pancreatic cancer is around 30% when complete resection can be achieved. Extended lymphatic resections may improve survival, but increases severe morbidity. As accurate patient selection should be mandatory, a new method is presented for pancreatic sentinel lymph node (SLN) detection with lymphoscintigraphy and gamma probe.

Materials and methods

Seven patients with cT2N0M0 pancreatic head cancer were enrolled between 2009 and 2012 in this prospective study. One day prior to surgery, preoperative lymphoscintigraphy with echoendoscopic intratumoural administration of Tc^99m-labelled nanocolloid was performed, with planar and SPECT-CT images obtained 2 h later. Gamma probe detection of SLN was also carried out during surgery.

Results

Radiotracer administration was feasible in all patients. Scintigraphy images showed inter-aortocaval lymph nodes in 2 patients, hepatoduodenal ligament lymph nodes in 1, intravascular injection in 3, intestinal transit in 5, and main pancreatic duct visualisation in 1. Surgical resection could only be achieved in 4 patients owing to locally advanced disease. Intraoperative SLN detection was accomplished in 2 patients, both with negative results. Only in one patient could SLN be confirmed as truly negative by final histopathological analysis.

Conclusions

This new method of pancreatic SLN detection is technically feasible, but challenging. Our preliminary results with 7 patients are not sufficient for clinical validation.