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[ Sentinel lymph node detection in colorectal cancer : importance , techniques and results ] . BACKGROUND AND AIM Considering that lymph node status is a key factor in colorectal cancer staging , and the main determinant for adjuvant therapy of colorectal cancer being this therapy , responsible for a significant increase in colorectal cancer patients survival , the staging methods should be the most accurate possible in order to offer this individuals the opportunity to be adequate treated in order to achieve the best survival possible . Sentinel lymph node study is progressively being popularized as a method that increases sensibility in detect positive nodes to reveal a more accurate stage and prognosis in colorectal cancer patients . PATIENTS AND METHODS Thirty one colorectal cancer patients were prospectively studied and sentinel lymph node was identified in 100 % of the cases utilizing either patent blue alone , or in association with radiotracer based on technetium 99m colloid solution in a randomized fashion . RESULTS The mean number of sentinel nodes per patient was 1.96 ranging from 1 to 3 nodes . With the addition of transoperative lympho-scintigraphy five extra sentinel nodes , not identified by the blue dye alone , were identified and considered for histopathology study . In four cases ( 12.9 % ) the sentinel lymph node was the only site of metastasis , all of them being detected by association of hematoxylin and eosin and immunohistochemical examination . CONCLUSION Sentinel lymph node detection and analysis is feasible , technique is relatively simple and is able to produce upstage in colorectal cancer . Blue staining and radio guided techniques are both safe and their superposition has shown good results in terms of increase accuracy in our experience . There was no aberrant lymph drainage that would alter resection margins in patients studied . Upstaging rate , identifying potential candidates for adjuvant therapy was 12.9 % ( 4/31 ) . To this individuals chemotherapy could be a chance to increase their global survival .
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Intervention_Pharmacological
adjuvant therapy
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Intervention_Physical
utilizing either patent blue alone , or in association with radiotracer based on technetium 99m colloid solution in a randomized fashion
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Intervention_Physical
Blue staining and radio guided techniques
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Intervention_Pharmacological
adjuvant therapy
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Intervention_Pharmacological
chemotherapy
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Outcome_Physical
Sentinel lymph node detection
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Outcome_Physical
sensibility in detect positive nodes
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Outcome_Physical
stage and prognosis
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Outcome_Other
mean number of sentinel nodes per patient
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Outcome_Physical
transoperative lympho-scintigraphy
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Outcome_Physical
extra sentinel nodes
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Outcome_Physical
association of hematoxylin and eosin and immunohistochemical examination
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Outcome_Other
feasible
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Outcome_Other
simple
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Outcome_Other
produce upstage
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Outcome_Other
safe
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Outcome_Other
accuracy
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Outcome_Physical
lymph drainage
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Outcome_Other
Upstaging rate