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J Thorac Cardiovasc Surg 2002;124:428-430
© 2002 The American Association for Thoracic Surgery

Editorials

Commentary on sentinel lymph node identification with technetium-99m tin colloid in non–small cell lung cancer

From the Section of Thoracic Surgery, Evanston Northwestern Healthcare, Evanston, Ill.

Received for publication April 23, 2002. Accepted for publication May 10, 2002. Address for reprints: Michael J. Liptay, MD, Head, Section of Thoracic Surgery, Evanston Northwestern Healthcare, Burch 100, 2650 Ridge Ave, Evanston, IL 60201 (E-mail: m-liptay@nwu.edu).

The first 20% of the full text of this article appears below.

	Introduction

 
See related article on page 486.

Sentinel node mapping techniques have been applied to the resection and treatment of nearly all solid tumors. The principle involves the injection of a lymphophylic tracer (either blue dye or a radioisotope) followed by visual or gamma counter measurements of individual lymph node stations to assess the first site of lymphatic drainage from a tumor. This sentinel nodal station should be the first site of lymphatic involvement if metastases have occurred.

The technique has become standard of care in both breast cancer and melanoma. The primary utility in these tumors is avoidance of nontherapeutic axillary or groin lymph node dissections and their incumbent morbidities. The morbidity of a complete mediastinal node dissection for lung cancer is not excessive and the procedure may be therapeutic. ^1,2

An equally important potential role may be directing pathologic examination to specific sentinel nodes and applying more sensitive techniques on a limited amount of tissue to detect occult micrometastatic disease.

Lymph node status is the single most important prognostic factor for localized potentially resectable non-small cell lung cancer. ³ Recent studies suggest that the presence of nodal micrometastatic disease in lung cancer may garner the same poor prognosis as metastases evident by conventional techniques. ^4,5 Nonetheless, more than 40% of "histologically node negative" patients who have a complete resection have a relapse and die of their original cancers, usually within 2 years. This is at least in part due to inaccurately staged nodal disease.

Sentinel . . . [Full Text of this Article]

Related Article

Use of technetium-99m tin colloid for sentinel lymph node identification in non–small cell lung cancer

Hiroaki Nomori, Hirotoshi Horio, Tsuguo Naruke, Hideki Orikasa, Kazuto Yamazaki, and Keiichi Suemasu
J. Thorac. Cardiovasc. Surg. 2002 124: 486-492. [Abstract] [Full Text] [PDF]

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