Initial experience in sentinel lymph node detection in pancreatic cancer

M. Beisani, I. Roca, R. Cardenas, L. Blanco, M. Abu-Suboh, J. Dot, J. R. Armengol, J. J. Olsina, J. Balsells, R. Charco, J. Castell

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Abstract

© 2015 Elsevier España, S.L.U. y SEMNIM Background The local recurrence of pancreatic cancer is around 30% when complete resection can be achieved. Extended lymphatic resections may improve survival, but increases severe morbidity. As accurate patient selection should be mandatory, a new method is presented for pancreatic sentinel lymph node (SLN) detection with lymphoscintigraphy and gamma probe. Materials and methods Seven patients with cT2N0M0 pancreatic head cancer were enrolled between 2009 and 2012 in this prospective study. One day prior to surgery, preoperative lymphoscintigraphy with echoendoscopic intratumoural administration of Tc99m-labelled nanocolloid was performed, with planar and SPECT-CT images obtained 2 h later. Gamma probe detection of SLN was also carried out during surgery. Results Radiotracer administration was feasible in all patients. Scintigraphy images showed inter-aortocaval lymph nodes in 2 patients, hepatoduodenal ligament lymph nodes in 1, intravascular injection in 3, intestinal transit in 5, and main pancreatic duct visualisation in 1. Surgical resection could only be achieved in 4 patients owing to locally advanced disease. Intraoperative SLN detection was accomplished in 2 patients, both with negative results. Only in one patient could SLN be confirmed as truly negative by final histopathological analysis. Conclusions This new method of pancreatic SLN detection is technically feasible, but challenging. Our preliminary results with 7 patients are not sufficient for clinical validation.
Original languageEnglish
Pages (from-to)287-291
JournalRevista Espanola de Medicina Nuclear e Imagen Molecular
Volume35
Issue number5
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Lymphoscintigraphy
  • Pancreatic cancer
  • Sentinel node

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    Beisani, M., Roca, I., Cardenas, R., Blanco, L., Abu-Suboh, M., Dot, J., Armengol, J. R., Olsina, J. J., Balsells, J., Charco, R., & Castell, J. (2016). Initial experience in sentinel lymph node detection in pancreatic cancer. Revista Espanola de Medicina Nuclear e Imagen Molecular, 35(5), 287-291. https://doi.org/10.1016/j.remn.2015.10.006