The Cancer Journal. 21(1):11–16, JANUARY/FEBRUARY 2015
DOI: 10.1097/PPO.0000000000000093
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PMID: 25611774
Issn Print: 1528-9117
Publication Date: January/February 2015
Sentinel Lymph Node Biopsy and Nodal Ultrastaging in Colorectal Cancer
Kelly Huynh;Anton Bilchik;
+ Author Information
From the Department of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA.
Abstract
The tumor status of the regional lymph nodes is the most important prognostic indicator in colorectal cancer (CRC), as it is in other solid tumors. Sentinel lymph node biopsy (SLNB), which has profoundly impacted the treatment of melanoma and breast cancer, has been applied in CRC in an attempt to improve nodal staging accuracy. The challenge lies in identifying patients who have tumor-negative nodes but are at high risk of regional or distant failure and therefore may benefit from adjuvant chemotherapy. Because standard pathological analysis of lymph nodes may incorrectly stage colon cancer, multiple studies have investigated nodal ultrastaging based on identification and immunohistochemical and/or molecular assessment of the sentinel node. This review focuses on the technique of SNLB, its feasibility and validity, and the controversies that remain regarding the clinical significance of nodal ultrastaging in CRC.
