Comparative analysis of colon cancer vs. rectal cancer in sentinel lymph node mapping

Abstract

INTRODUCTION: The lymphatic status is acknowledged as the most important prognostic factor in patients with colorectal cancer. In our clinic, the intraoperative sentinel lymph node mapping with Patent Blue V is a routine method of choice for better staging of lymph node status and achieving an adequate extent of surgical procedure in patients with colorectal cancer. AIM: To compare the results from application of methods of intraoperative sentinel lymph node mapping in patients with colon cancer vs patients with rectal cancer. RESULTS: There were 136 con secutive patients (65 with colon and 71 with rectum). The sentinel lymph nodes were identified in 100 percent of colon and rectal patients. Skip metastases were found in 3.0 percent of colon vs. 2.81 percent of rectal patients. Occult micrometastases were found in 9 percent of colon vs. 7.0 percent of rectal patients. No other parameters were statistically different between colon and rectum. The study was under gone in 136 patients with diagnosis of colorectal cancer and sentinel lymph node mapping. An analysis and comparison is done and the results of the two methods were compared. Our data show that the sensitivity is comparable and is respectively 100% and 95%, respectively for the colon and rectum, the methods are reliable enough. CONCLUSION: The surgical approach and the extent of the lymph dissection have to be conformable to the status of lymph node basin, staged with the help of objective intraoperative diagnostic tool, such as intraoperative sentinel lymph node mapping. This leads to increasing level of curative surgical treatment in cases of colorectal cancer. Despite higher success rates in sentinel lymph node identification for colon patients, sentinel lymph node mapping was highly successful (91.5 percent) in rectal patients. Nodal upstaging, skip metastases, and occult metastases were analysed. Scripta Scientifica Medica 2010;42(1): 35-39