Abstract
When cancer cells spread through lymphatic vessels, the first lymph node they reach is the sentinel lymph node (SLN). Hence, if the SLN is free from metastatic cells, it can be assumed that further lymph nodes will be free of metastatic tumor cells too. If metastatic tumor cells are identified in the SLN, the patient is at risk of developing distant metastatic disease. In that case, further diagnostic and therapeutic steps are needed and the patient’s prognosis gets worse. The SLN can be located at an anatomically unpredictable location. This is likely due to lymphangiogenesis, which alters the normal lymphatic pathway and drains the metastatic cells to another lymph node than the expected anatomically closest one. Therefore, identifying the SLN by an accurate mapping technique is necessary. In this article, the existing techniques for SLN mapping are reviewed, and their use in human and veterinary medicine is compared.
Highlights
Metastatic spread is one of the most important causes of death in both human and canine cancer patients (Bonnett et al, 1997; Warland et al, 2014)
If the sentinel lymph node (SLN) is free from metastatic cells, it can be assumed that further lymph nodes will be free of metastatic tumor cells too
It goes without saying that the SLN is a central aspect in staging cancer patients
Summary
Metastatic spread is one of the most important causes of death in both human and canine cancer patients (Bonnett et al, 1997; Warland et al, 2014). If the SLN is negative for cancer cells on both hematoxylin and eosin stain and immunohistochemistry, it can be assumed that anatomically further located LNs will be free of metastatic tumor cells (Turner et al, 1997; Worley 2014). Acquiring multiple samples from the same LN decrease the likelihood of false negatives, but this might be challenging in clinical practice (Barui et al, 2017) Another important limitation of FNA is that not all LN are reachable for palpation and/or FNA and patients can be inaccurately staged when their SLN does not correspond to the anatomically expected one (Rossi et al, 2018). The SLN concept has been investigated in only a few studies, and SLN mapping studies are often performed in a limited population and/or for selected tumor types (Rossi et al, 2007; Mayer et al, 2012; Mayer et al, 2013; Worley, 2014; Beserra et al, 2016; Brissot and Edery, 2016; Soultani et al, 2016; Grimes et al, 2017; Majeski et al, 2017; Favril et al, 2018; Fournier et al, 2020)
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