Sentinel lymph node mapping in patients with operable non-small cell lung cancer

Background

The aim of this study was to determine the accuracy and the role of the sentinel lymph node (SLN) in patients with non-small cell lung cancer.

Material and method

This study was carried out on 25 consecutive patients [M/F=23^:2, mean age 62.84 (47-81) years] with operable non-small cell lung cancer (NSCLC). At thoracotomy, 0.25 mCi of Technecium^99m (99mTc) nanocolloid was injected into each quadrant of lung tissue surrounding the tumor. Before resection scintigraphic measurements of lymph nodes were obtained in vivo and ex vivo using a hand-held gamma probe counter and the findings were compared with histological examination. SLN was defined as the node with the highest count rate.

Results

SLNs were identified in 23 of 25 patients (92%) with a total number of 52 SLNs. Seven of 52 (13%) of these SLNs were positive for metastatic involvement after histological and immunohistochemical examination. In two patients (8%), SLNs could not be found. The sensitivity and specificity were 55% and 86% respectively.

Conclusions

This technic is a good method for identifying the first site of potential nodal metastases of NSCLC. These preliminary results demonstrate this procedure is feasible, but the detection rate has to be improved.KEY WORDS : Non-small-cell lung carcinoma (NSCLC), sentinel lymph node, 99mTc nanocolloid, lymph node intraoperative detection, nodal dissection