scholarly journals Applicability of sentinel lymph node oriented treatment strategy for gallbladder cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247079
Author(s):  
Koya Yasukawa ◽  
Akira Shimizu ◽  
Hiroaki Motoyama ◽  
Koji Kubota ◽  
Tsuyoshi Notake ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Gallbladder Cancer ◽  
Disease Free Survival ◽  
Free Survival ◽  
Node Disease ◽  
Local Lymph Node ◽  
The Relationship ◽  
Disease Free ◽  
Better Than

Background Utility of the sentinel lymph node (SLN) biopsy in some malignancies has been reported, however, research on that of gallbladder cancer (GBC) is rare. The aim of this study is to investigate whether the concept of SLN is applicable to T2/3 GBC. Methods A total of 80 patients who underwent resection for gallbladder cancer were enrolled in this study. Patients with GBC were stratified into two groups based on the location of tumor, peritoneal-side (T2p or 3p) and hepatic-side (T2h or 3h) groups. We evaluated the relationship between cystic duct node (CDN) and downstream lymph node (LN) status. CDN was defined as a SLN in this study. Results Thirty-eight patients were classified into T2, including T2p (n = 18) and T2h (n = 20), and 42 patients into T3, including T3p (n = 22) andT3h (n = 20). The incidence of LN metastasis was significantly higher in hepatic-side than peritoneal-side in both T2 and T3 (P = 0.036 and 0.009, respectively). In T2, 14 T2p had negative CDN and downstream LN, however, three T2h had negative CDN and positive downstream LNs (defined as a skipped LN metastasis) (P = 0.043). In T3, patients with skipped LN metastasis were significantly higher in T3h (n = 11) than those in T3p (n = 2) (P<0.001). There was no recurrence of the local lymph node. Disease-free survival in the T2p and T3p were significantly better than those in the T2h and T3h (P = 0.005 and 0.025, respectively). Conclusion The concept of SLN can be applicable to T2p GBC, where the downstream LNs dissection can be omitted.

scholarly journals Influence of Sentinel Lymph Node Biopsy on Disease-Free Survival for Melanoma Patients

2014 ◽  
Vol 25 ◽  
pp. iv388
Author(s):  
M. Kukushkina ◽  
S. Korovin ◽  
O. Solodiannikova ◽  
G. Sukach ◽  
A. Palivets ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Disease Free Survival ◽  
Lymph Node Biopsy ◽  
Free Survival ◽  
Node Biopsy ◽  
Melanoma Patients ◽  
Disease Free

scholarly journals Association Between Circulating Tumor Cells and Prognosis in Patients With Stage III Melanoma With Sentinel Lymph Node Metastasis in a Phase III International Multicenter Trial

2012 ◽  
Vol 30 (31) ◽  
pp. 3819-3826 ◽  
Author(s):  
Sojun Hoshimoto ◽  
Tatsushi Shingai ◽  
Donald L. Morton ◽  
Christine Kuo ◽  
Mark B. Faries ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Tumor Cells ◽  
Distant Metastasis ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
International Multicenter ◽  
Disease Free

PurposeThe outcomes of patients with melanoma who have sentinel lymph node (SLN) metastases can be highly variable, which has precluded establishment of consensus regarding treatment of the group. The detection of high-risk patients from this clinical setting may be helpful for determination of both prognosis and management. We report the utility of multimarker reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR) detection of circulating tumor cells (CTCs) in patients with melanoma diagnosed with SLN metastases in a phase III, international, multicenter clinical trial.Patients and MethodsBlood specimens were collected from patients with melanoma (n = 331) who were clinically disease-free after complete lymphadenectomy (CLND) before entering onto a randomized adjuvant melanoma vaccine plus bacillus Calmette-Guérin (BCG) versus BCG placebo trial from 30 melanoma centers (United States and international). Blood was assessed using a verified multimarker RT-qPCR assay (MART-1, MAGE-A3, and GalNAc-T) of melanoma-associated proteins. Cox regression analyses were used to evaluate the prognostic significance of CTC status for disease recurrence and melanoma-specific survival (MSS).ResultsIndividual CTC biomarker detection ranged from 13.4% to 17.5%. There was no association of CTC status (zero to one positive biomarkers v two or more positive biomarkers) with known clinical or pathologic prognostic variables. However, two or more positive biomarkers was significantly associated with worse distant metastasis disease-free survival (hazard ratio [HR] = 2.13, P = .009) and reduced recurrence-free survival (HR = 1.70, P = .046) and MSS (HR = 1.88, P = .043) in a multivariable analysis.ConclusionCTC biomarker status is a prognostic factor for recurrence-free survival, distant metastasis disease-free survival, and MSS after CLND in patients with SLN metastasis. This multimarker RT-qPCR analysis may therefore be useful in discriminating patients who may benefit from aggressive adjuvant therapy or stratifying patients for adjuvant clinical trials.

Neck Dissections Based on Sentinel Lymph Node Navigation Versus Elective Neck Dissections in Early Oral Cancers: A Randomized, Multicenter, and Noninferiority Trial

2021 ◽  
pp. JCO.20.03637
Author(s):  
Yasuhisa Hasegawa ◽  
Kiyoaki Tsukahara ◽  
Seiichi Yoshimoto ◽  
Kouki Miura ◽  
Junkichi Yokoyama ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Survival Rate ◽  
Sentinel Lymph Node ◽  
Lower Limit ◽  
Disease Free Survival ◽  
Sentinel Lymph Nodes ◽  
Free Survival ◽  
Node Negative ◽  
Disease Free

PURPOSE This study aimed to compare patients with early oral cavity squamous cell carcinoma (OCSCC) (tumor category [T] 1-2, node-negative, and no distant metastasis) treated with traditional elective neck dissection (ND) with those managed by sentinel lymph node biopsy (SLNB) using survival and neck function and complications as end points. METHODS Sixteen institutions in Japan participated in the study (trial registration number: UMIN000006510). Patients of age ≥ 18 years with histologically confirmed, previously untreated OCSCC (Union for International Cancer Control TNM Classification of Malignant Tumors 7th edition T1-2, node-negative no distant metastasis), with ≥ 4 mm (T1) depth of invasion, were randomly assigned to undergo standard selective ND (ND group; n = 137) or SLNB-navigated ND (SLNB group; n = 134). The primary end point was the 3-year overall survival rate, with a 12% noninferiority margin; secondary end points included postoperative neck functionality and complications and 3-year disease-free survival. Sentinel lymph nodes underwent intraoperative multislice frozen section analyses for the diagnosis. Patients with positive sentinel lymph nodes underwent either one-stage or second-look ND. RESULTS Pathologic metastasis-positive nodes were observed in 24.8% (34 of 137) and 33.6% (46 of 134) of patients in the ND and SLNB groups, respectively ( P = .190). The 3-year overall survival in the SLNB group (87.9%; lower limit of one-sided 95% CI, 82.4) was noninferior to that in the ND group (86.6%; lower limit 95% CI, 80.9; P for noninferiority < .001). The 3-year disease-free survival rate was 78.7% (lower limit 95% CI, 72.1) and 81.3% (75.0) in the SLNB and ND groups, respectively ( P for noninferiority < .001). The scores of neck functionality in the SLNB group were significantly better than those in the ND group. CONCLUSION SLNB-navigated ND may replace elective ND without a survival disadvantage and reduce postoperative neck disability in patients with early-stage OCSCC.

scholarly journals Survival of patients with localized diffuse histiocytic lymphoma

Blood ◽  
1981 ◽  
Vol 58 (6) ◽  
pp. 1218-1223 ◽  
Author(s):  
DL Sweet ◽  
J Kinzie ◽  
ME Gaeke ◽  
HM Golomb ◽  
DL Ferguson ◽  
...  
Keyword(s):  
Lymph Node ◽  
Median Survival ◽  
Disease Free Survival ◽  
Stage I ◽  
Stage Ii ◽  
Free Survival ◽  
Histiocytic Lymphoma ◽  
Node Disease ◽  
Diffuse Histiocytic Lymphoma ◽  
Disease Free

Twenty-eight patients with previously untreated diffuse histiocytic lymphoma (DHL) were identified to be in pathologic stage (PS) I (11), IE (3), II (8), or IIE (6) by exploratory laparotomy and splenectomy. Six patients were treated with total nodal radiotherapy; 14 with an extended mantle; 5 with an inverted Y or whole abdomen; and 3 with an involved field. Twenty-six patients achieved a complete remission (93%) and 2 patients had persistent local disease. The median survival and disease-free survival and for the complete response group are 56 and 51.5 mo, respectively. Ten of the 11 stage I or IE patients had supradiaphragmatic lymph node disease. Patients with stage I or IE disease (n = 14) demonstrated a median survival of 72.5 mo and a median disease-free survival of 69.5 mo; there was 1 disease-related death. Patients with stage II or IIE disease (n = 14) demonstrated a median survival of 33 mo and median disease-free survival of 29.5 mo; there were 10 relapses or deaths. Patients in stages I, IE, II, or IIE with infradiaphragmatic disease (n = 7) had a median survival of 36 mo, while patients with supradiaphragmatic presentation (n = 21) demonstrated median survival of 68 mo (p = 0.37). The data indicate that patients with diffuse histiocytic lymphoma with stage I supradiaphragmatic lymph node disease are curable using radiotherapy alone, achieving a 93% 11-yr actuarial disease-free survival. Patients with stage II or IIE diseases are not readily curable with radiation therapy alone, achieving a 33% 11-yr actuarial disease-free survival; radiotherapy with adjuvant chemotherapy or chemotherapy alone should be considered for this group.

scholarly journals Sentinel lymph node B cells can predict disease-free survival in breast cancer patients

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Kim R. M. Blenman ◽  
Ting-Fang He ◽  
Paul H. Frankel ◽  
Nora H. Ruel ◽  
Erich J. Schwartz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
B Cells ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free

scholarly journals Survival of patients with localized diffuse histiocytic lymphoma

Blood ◽  
1981 ◽  
Vol 58 (6) ◽  
pp. 1218-1223 ◽  
Author(s):  
DL Sweet ◽  
J Kinzie ◽  
ME Gaeke ◽  
HM Golomb ◽  
DL Ferguson ◽  
...  
Keyword(s):  
Lymph Node ◽  
Median Survival ◽  
Disease Free Survival ◽  
Stage I ◽  
Stage Ii ◽  
Free Survival ◽  
Histiocytic Lymphoma ◽  
Node Disease ◽  
Diffuse Histiocytic Lymphoma ◽  
Disease Free

Abstract Twenty-eight patients with previously untreated diffuse histiocytic lymphoma (DHL) were identified to be in pathologic stage (PS) I (11), IE (3), II (8), or IIE (6) by exploratory laparotomy and splenectomy. Six patients were treated with total nodal radiotherapy; 14 with an extended mantle; 5 with an inverted Y or whole abdomen; and 3 with an involved field. Twenty-six patients achieved a complete remission (93%) and 2 patients had persistent local disease. The median survival and disease-free survival and for the complete response group are 56 and 51.5 mo, respectively. Ten of the 11 stage I or IE patients had supradiaphragmatic lymph node disease. Patients with stage I or IE disease (n = 14) demonstrated a median survival of 72.5 mo and a median disease-free survival of 69.5 mo; there was 1 disease-related death. Patients with stage II or IIE disease (n = 14) demonstrated a median survival of 33 mo and median disease-free survival of 29.5 mo; there were 10 relapses or deaths. Patients in stages I, IE, II, or IIE with infradiaphragmatic disease (n = 7) had a median survival of 36 mo, while patients with supradiaphragmatic presentation (n = 21) demonstrated median survival of 68 mo (p = 0.37). The data indicate that patients with diffuse histiocytic lymphoma with stage I supradiaphragmatic lymph node disease are curable using radiotherapy alone, achieving a 93% 11-yr actuarial disease-free survival. Patients with stage II or IIE diseases are not readily curable with radiation therapy alone, achieving a 33% 11-yr actuarial disease-free survival; radiotherapy with adjuvant chemotherapy or chemotherapy alone should be considered for this group.

scholarly journals Lymphadenectomy after a positive sentinel node biopsy in patients with cutaneous melanoma. A systematic review

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Maribel L. Da Cunha Cosme ◽  
Juan F. Liuzzi Samaterra ◽  
Saul A. Siso Cardenas ◽  
José I. Chaviano Hernández
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Disease Free Survival ◽  
Lymph Node Biopsy ◽  
Positive Sentinel Node ◽  
Free Survival ◽  
Node Biopsy ◽  
Disease Free

AbstractComplete lymph node dissection (CLND) following a positive sentinel lymph node biopsy (SLNB) has been the standard treatment for years. However, there is increasing evidence that CLND could be omitted. Approximately 80% of patients with a positive sentinel node biopsy do not have additional nodal involvement; in these contexts, the SLNB could be diagnostic and therapeutic. However, in this group of patients, the therapeutic effect of CLND is unclear.A systematic search was performed in EMBASE and MEDLINE (PubMed), for studies published between January 1, 2014 and December 31, 2019. Studies were included when they compared immediate CLND and observation after a positive sentinel node. The outcomes of interest were: Overall Survival (OS), melanoma-specific survival (MSS), and disease-free survival (DFS).Eleven studies met the inclusion criteria. Two randomized clinical trials reported no differences in OS or MSS when complete lymph dissection was compared with observation alone. An increase in regional relapse was observed in the CLND group, and in one randomized controlled trial (RCT) the rate of disease-free survival was superior in those patients.Most populations in both RCTs had low sentinel lymph node biopsy (SLNB) metastatic deposits, and head and neck melanomas were not included or underrepresented. When CNLD was omitted, an active surveillance protocol was carried out.The evidence supports that CLND in SLNB positive patients does not confer a survival benefit. Sentinel tumor burden, localization of primary tumor, and feasibility of active surveillance should be taken into account in treatment decisions.

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