Limits...
Beyond penile cancer, is there a role for sentinel node biopsy in urological malignancies?

View Article: PubMed Central - PubMed

ABSTRACT

This review aims to discuss the current state-of-the-art of sentinel node (SN) mapping in urological malignancies. The principles and methodological aspects of lymphatic mapping and SN biopsy in urological malignancies are reviewed. Literature search was restricted to English language. The references of the retrieved articles were examined to identify additional articles. The review also includes meta-analyses published in the past 5 years. SN biopsy for penile cancer is recommended by the European Association of Urology as the preferred staging tool for clinically node-negative patients with at least T1G2 tumours (level of evidence 2a, Grade B). The feasibility of SN biopsy in prostate cancer has been repeatedly demonstrated and its potential value is increasingly being recognised. However, conclusive prospective clinical data as well as consensus on methodology and patient selection are still lacking. For bladder, renal and testicular cancer, only few studies have been published, and concerns around high false-negative rates remain. Throughout the years, the uro-oncological field has portrayed a pivotal role in the development of the SN concept. Recent advances such as hybrid tracers and novel intraoperative detection tools such as fluorescence and portable gamma imaging will hopefully encourage prospectively designed clinical trials which can further substantiate the potential of the SN approach in becoming an integral part of staging in urological malignancies beyond penile cancer.

No MeSH data available.


Related in: MedlinePlus

Sentinel node localisation in prostate cancer after administration of 99mTc-nanocolloid. Coronal volume rendering (a) and transversal (b, c) SPECT/CT showing two sentinel nodes along the left common iliac artery. Based on this anatomical information both nodes are subsequently removed (d) laparoscopically, guided by a portable gamma camera (e)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5037151&req=5

Fig3: Sentinel node localisation in prostate cancer after administration of 99mTc-nanocolloid. Coronal volume rendering (a) and transversal (b, c) SPECT/CT showing two sentinel nodes along the left common iliac artery. Based on this anatomical information both nodes are subsequently removed (d) laparoscopically, guided by a portable gamma camera (e)

Mentions: Currently, the intraoperative procedure is generally carried out using a minimally invasive (laparoscopic and robot-assisted) approach. During laparoscopic surgery, the urologist traditionally localises an SN under guidance by the sound pitch originated by the laparoscopic gamma-probe. However, intraoperative spatial orientation using this device can sometimes be cumbersome, as a laparoscopic probe does not provide visual information. A particular innovation in the SN procedure for prostate cancer has been illustrated in recent years by the use of portable gamma to intraoperatively provide a two-dimensional image of the radioactive SNs (Fig. 3). The imaging system was shown to aid in confirmation of accurate SN removal in the laparoscopic setting [82, 83]. Current portable gamma cameras are capable of detecting two different signals: the signal of 99mTc-nanocolloid for the visualisation of SNs, plus the signal of an iodine-125 (125I) seed pointer placed on the tip of the laparoscopic gamma-ray detection probe. The “hot” tip of the probe can be moved to the hot node, guided by the image of the portable camera (Fig. 3). This approach helps navigate towards the location of the SNs. Recent studies have also explored using the preoperatively acquired SPECT/CT images for intraoperative navigation (virtual/mixed reality) [84, 85].Fig. 3


Beyond penile cancer, is there a role for sentinel node biopsy in urological malignancies?
Sentinel node localisation in prostate cancer after administration of 99mTc-nanocolloid. Coronal volume rendering (a) and transversal (b, c) SPECT/CT showing two sentinel nodes along the left common iliac artery. Based on this anatomical information both nodes are subsequently removed (d) laparoscopically, guided by a portable gamma camera (e)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037151&req=5

Fig3: Sentinel node localisation in prostate cancer after administration of 99mTc-nanocolloid. Coronal volume rendering (a) and transversal (b, c) SPECT/CT showing two sentinel nodes along the left common iliac artery. Based on this anatomical information both nodes are subsequently removed (d) laparoscopically, guided by a portable gamma camera (e)
Mentions: Currently, the intraoperative procedure is generally carried out using a minimally invasive (laparoscopic and robot-assisted) approach. During laparoscopic surgery, the urologist traditionally localises an SN under guidance by the sound pitch originated by the laparoscopic gamma-probe. However, intraoperative spatial orientation using this device can sometimes be cumbersome, as a laparoscopic probe does not provide visual information. A particular innovation in the SN procedure for prostate cancer has been illustrated in recent years by the use of portable gamma to intraoperatively provide a two-dimensional image of the radioactive SNs (Fig. 3). The imaging system was shown to aid in confirmation of accurate SN removal in the laparoscopic setting [82, 83]. Current portable gamma cameras are capable of detecting two different signals: the signal of 99mTc-nanocolloid for the visualisation of SNs, plus the signal of an iodine-125 (125I) seed pointer placed on the tip of the laparoscopic gamma-ray detection probe. The “hot” tip of the probe can be moved to the hot node, guided by the image of the portable camera (Fig. 3). This approach helps navigate towards the location of the SNs. Recent studies have also explored using the preoperatively acquired SPECT/CT images for intraoperative navigation (virtual/mixed reality) [84, 85].Fig. 3

View Article: PubMed Central - PubMed

ABSTRACT

This review aims to discuss the current state-of-the-art of sentinel node (SN) mapping in urological malignancies. The principles and methodological aspects of lymphatic mapping and SN biopsy in urological malignancies are reviewed. Literature search was restricted to English language. The references of the retrieved articles were examined to identify additional articles. The review also includes meta-analyses published in the past 5 years. SN biopsy for penile cancer is recommended by the European Association of Urology as the preferred staging tool for clinically node-negative patients with at least T1G2 tumours (level of evidence 2a, Grade B). The feasibility of SN biopsy in prostate cancer has been repeatedly demonstrated and its potential value is increasingly being recognised. However, conclusive prospective clinical data as well as consensus on methodology and patient selection are still lacking. For bladder, renal and testicular cancer, only few studies have been published, and concerns around high false-negative rates remain. Throughout the years, the uro-oncological field has portrayed a pivotal role in the development of the SN concept. Recent advances such as hybrid tracers and novel intraoperative detection tools such as fluorescence and portable gamma imaging will hopefully encourage prospectively designed clinical trials which can further substantiate the potential of the SN approach in becoming an integral part of staging in urological malignancies beyond penile cancer.

No MeSH data available.


Related in: MedlinePlus