scholarly journals Assessing the Risk of Nodal Metastases in Canine Integumentary Mast Cell Tumors: Is Sentinel Lymph Node Biopsy Always Necessary?

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2373
Author(s):  
Roberta Ferrari ◽  
Patrizia Boracchi ◽  
Lavinia Elena Chiti ◽  
Martina Manfredi ◽  
Chiara Giudice ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Regional Lymph Node ◽  
Strong Association ◽  
Lymph Node Biopsy ◽  
Occult Metastasis ◽  
Low Grade ◽  
Mast Cell Tumors ◽  
Study Results ◽  
Clinicopathological Variables

The recent literature supports the sentinel lymph node (SLN) biopsy in dogs with MCT due to discrepancy with the regional lymph node and the high percentage of occult metastasis. However, the SLN biopsy includes additional anesthesiologic, diagnostic, and surgical procedures, and additional costs. The study aimed to assess the association between clinicopathological variables and SLN status, determining the identification of dogs at lower risk of SLN metastases. Dogs with integumentary MCT were admitted to the lymphoscintigraphic mapping and subsequent biopsy of SLN. The association between clinicopathological variables of MCT and SLN status was statistically tested, both considering occult and overt metastasis together (HN2-HN3) and overt metastasis (HN3) alone. Fifty low-grade cutaneous MCT and 16 subcutaneous MCT were included. A small to moderate association between integumentary MCT ≥ 3 cm and HN2-HN3 SLN was found. A strong association of integumentary MCT dimension and subcutaneous MCT with HN3 SLN occurred. Dimension of low-grade cutaneous and subcutaneous MCT seems to correlate with SLN status, but additional study should confirm this data before excluding small MCT to the SLN biopsy. On the contrary, the study results induce a solid suggestion for mapping and biopsy of the SLN in MCT > 3 cm and subcutaneous MCT.

Defining the learning curve for successful staging with sentinel lymph node biopsy for endometrial cancer among surgeons at an academic institution

2020 ◽  
Vol 30 (3) ◽  
pp. 346-351
Author(s):  
Katherine Tucker ◽  
Stuart-Allison Staley ◽  
Paola A Gehrig ◽  
John T Soper ◽  
John F Boggess ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Learning Curve ◽  
Early Stage ◽  
Lymph Node Biopsy ◽  
Academic Program ◽  
Academic Institution ◽  
Low Grade ◽  
Surgical Data

BackgroundSentinel lymph node (SLN) biopsy is increasingly used in endometrial cancer staging; however, success of the technique is variable, and the learning curve needs to be better understood. Success is defined as identification of a SLN specimen containing nodal tissue in bilateral hemi-pelvises.ObjectiveTo assess the learning curve of surgeons at an academic institution in performing successful SLN mapping and biopsy during robotic staging for endometrial cancer.MethodsAfter institutional review board approval, patients who underwent staging with robotic SLN mapping using indocyanine green at a single academic program between July 2012 and December 2017 were identified. Demographic, pathologic, and surgical data were retrospectively collected from the medical records. Descriptive and comparative statistics were performed. Surgeon rates of successful bilateral SLN mapping and removal of lymphoid-containing SLN specimens were compared. A logistic model was used to analyze the probability of successful SLN mapping and removal of lymph node-containing tissue with increasing number of procedures performed.ResultsThree hundred and seventeen patients met the eligibility criteria. Most had early-stage, low-grade endometrial cancer. A total of 194 (61%) patients had successful bilateral mapping. Among seven surgeons, a plateau in rates of successful bilateral mapping was achieved after 40 cases. No linear correlation was seen between the number of surgeries performed and the rate of removal of lymph node-containing tissue among surgeons. Each additional 10 procedures performed was associated with a 5% and an 11% increase in the odds of successful SLN mapping and removal of lymph node-containing tissue, respectively.DiscussionThe successful removal of lymph node-containing specimens appears to be a surgeon-specific phenomenon. The plateau of the learning curve for successful bilateral mapping seems to be reached at around 40 cases. These first 40 cases offer a time for auditing of individual rates of SLN mapping and removal to identify surgeons who may benefit from procedure-specific remediation.

scholarly journals Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis

2019 ◽  
Vol 26 (3) ◽  
pp. 1861-1868
Author(s):  
A. Kocsis ◽  
L. Karsko ◽  
Zs. Kurgyis ◽  
Zs. Besenyi ◽  
L. Pavics ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Regional Lymph Node ◽  
Mitotic Rate ◽  
Lymph Node Biopsy ◽  
Mitotic Figure ◽  
Lymph Node Staging ◽  
Thin Melanoma ◽  
Node Biopsy

AbstractSentinel lymph node biopsy (SLNB) is a standard procedure for regional lymph node staging and still has the most important prognostic value for the outcome of patients with thin melanoma. In addition to ulceration, SLNB had to be considered even for a single mitotic figure in thin (<1 mm) melanoma according to AJCC7th guideline, therefore, a retrospective review was conducted involving 403 pT1 melanoma patients. Among them, 152 patients suffered from pT1b ulcerated or mitotic rate ≥ 1/ mm2 melanomas according to the AJCC7th staging system. SLNB was performed in 78 cases, of which nine (11.5%) showed SLN positivity. From them, interestingly, we found a relatively high positive sentinel rate (6/78–8%) in the case of thin primary melanomas ˂0.8 mm. Moreover, the presence of regression increased the probability of sentinel positivity by 5.796 fold. After reassessing pT stage based on the new AJCC8th, 37 pT1b cases were reordered into pT1a category. There was no significant relation between other characteristics examined (age, gender, Breslow, Clark level, and mitosis index) and sentinel node positivity. Based on our data, we suggest that mitotic rate alone is not a sufficiently powerful predictor of SLN status in thin melanomas. If strict histopathological definition criteria are applied, regression might be an additional adverse feature that aids in identifying T1 patients most likely to be SLN-positive. After reassessing of pT1b cases according to AJCC8th regression proved to be independent prognostic factor on sentinel lymph node positivity. Our results propose that sentinel lymph node biopsy might also be considered at patients with regressive thin (˂0.8 mm) melanomas.

S-classification of sentinel lymph node biopsy predicts the results of complete regional lymph node dissection

2005 ◽  
Vol 15 (4) ◽  
pp. 267-271 ◽  
Author(s):  
Astrid M. Fink ◽  
Felix Weihsengruber ◽  
Bernhard Spangl ◽  
Hans Feichtinger ◽  
Nikolaus Lilgenau ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Dissection ◽  
Regional Lymph Node ◽  
Lymph Node Biopsy ◽  
Node Dissection ◽  
Node Biopsy ◽  
Regional Lymph Node Dissection

scholarly journals Animal model for training in sentinel lymph node biopsy of the stomach through combined methods

2012 ◽  
Vol 27 (12) ◽  
pp. 833-840 ◽  
Author(s):  
José Roberto Alves ◽  
Luiz Roberto Lopes ◽  
Luciana Rodrigues de Meirelles ◽  
Celso Darío Ramos ◽  
Tânia Sasasaki ◽  
...  
Keyword(s):  
Animal Model ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Histological Study ◽  
Radiation Detector ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Study Results

PURPOSE: Create and validate a proposed animal model for training in sentinel lymph node biopsy of the stomach. METHODS: In thirty-two rabbits, through a laparotomy, they received a subserosal injection of 0.1 ml of phytate labeled with technetium-99m (0.2 mCi) in the anterior wall of the gastric corpus, followed by 0.2 ml of Blue Patent V® 2.5%, through the same puncture site. Suspicious lymph nodes were searched in vivo at five, ten and 20 minutes, both visually (Blue Patent stained lymph nodes) and with a manual gamma radiation detector (to detect suspected radioactive lymph nodes). After 20 minutes, was performed resection of these for further evaluation of radioactivity (ex vivo) and histological study. RESULTS: Lymph nodes were identified in 30 rabbits (Average of 2.2 lymph nodes per animal). Of the 90 suspected lymph nodes that occurred in the study, 70 cases (77.8%) were histologically confirmed for lymphoid tissue. Of these, the majority were located in the periesophageal region of the gastric fundus. The sample presented a mortality rate of 6.25% and nine complications related to the method, which interfered in the identification of the lymph nodes. CONCLUSION: The animal model for sentinel node biopsy in rabbit stomachs proved to be feasible, with low complexity and reproduced the difficulties encountered for gastric lymph node biopsy in humans, being adequate for surgical training.

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