Selective Sentinel Lymphadenectomy for Human Solid Cancer

314 Pages·2005·50.38 MB·English

by  Jan H. Wong (auth.), Stanley P. L. Leong, Yuko Kitagawa, Masaki Kitajima (eds.)

SELECTIVE SENTINEL
LYMPHADENECTOMY FOR
HUMAN SOLID CANCER
Cancer Treatment and Research
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Leong, Stanley P.L., Kitagawa, Y., Kitajima, M. (eds.): Selective Sentinel Lymphadenectomy for Human
Solid Cancer 2005. ISBN 0-387-23603-1.
SELECTIVE SENTINEL
LYMPHADENECTOMY FOR
HUMAN SOLID CANCER
edited by
STANLEY P. L. LEONG, MD, FACS
Professor and Director of Sentinel Lymph Node Program
University of California San Francisco Medical Center
at Mount Zion
San Francisco, CA, USA
YUKO KITAGAWA, MD, PhD, FACS
Assistant Professor of Surgery
Keio University School of Medicine
Tokyo, Japan
MASAKIKITAJIMA, MD, FACS
Professor and Chairman of Surgery
Keio University School of Medicine
Tokyo, Japan
Springer
Stanley P. L. Leong Yuko Kitagawa / Masaki Kitajima
Department of Surgery Department of Surgery
University of California Keio University
Medical Center at Mount Zion School of Medicine
1600 Divisadero Street 35 Shinanomachi, Shinjuku-ku
San Francisco, CA 94143 Tokyo 160-8582, Japan
[email protected] [email protected]
[email protected]
Selective Sentinel Lymphadenectomy for Human Solid Cancer
Library of Congress Cataloging-in-Publication Data
A CLP. Catalogue record for this book is available
from the Library of Congress.
ISBN 0-387-23603-1 e-ISBN 0-387-23604-X Printed on acid-free paper.
© 2005 Springer Science+Business Media, Inc.
All rights reserved. This work may not be translated or copied in whole or in part without
the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring
Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or
scholarly analysis. Use in connection with any form of information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar methodology now
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even if the are not identified as such, is not to be taken as an expression of opinion as to
whether or not they are subject to proprietary rights.
Printed in the United States of America.
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CONTENTS
Preface vii
Foreword xi
Acknowledgments xv
Contributors xvii
1. The Development of Lymphatic Mapping and Sentinel 1
Lymphadenectomy: A Historical Perspective
Jan H. Wong
2. Role of Lymphoscintigraphy for Selective Sentinel 15
Lymphadenectomy
Roger F. Uren, Robert B. Howman-Giles, David Chung,
John F. Thompson
3. Selective Sentinel Lymphadenectomy for Malignant 39
Melanoma, Merkel Cell Carcinoma, and Squamous
Cell Carcinoma: Selective Sentinel Lymphadenectomy
for Cutaneous Malignancy
Stanley P. L. Leong
4. Selective Sentinel Lymphadenectomy for Breast Cancer 77
Charles E. Cox, Elizabeth S. Weinberg, Ben Furman,
Laura B. White, Jayesh Patel, Daniel C. Dickson, Jeff King
5. Sentinel Lymph Node Mapping in Colon and Rectal 105
Cancer: Its Impact on Staging, Limitations, and Pitfalls
Sukamal Saha, Adrian G. Dan, Carsten T. Viehl,
Markus Zuber, David Wiese
6. Sentinel Lymph Node Mapping in Esophageal and 123
Gastric Cancer
Yuko Kitagawa, Hirofumi Fujii, Makio Mukai, Atsushi
Kubo, Masaki Kitajima
7. Sentinel Lymph Node Mapping in Lung Cancer 141
Michael J. Liptay
vi
8 Lymphatic Mapping and Sentinel Lymphadenectomy in 151
Urology
Ramon M. Cabanas
9. Selective Sentinel Lymphadenectomy for Gynecologic 167
Cancer
Charles Levenback
10. Selective Sentinel Lymphadenectomy for Head and 187
Neck Squamous Cell Carcinoma
Jochen A. Werner
11. Accurate Evaluation of Nodal Tissues for the Presence 207
of Tumor Is Central to the Sentinel Node Approach
Alistair J. Cochran, Alice Roberts, Duan-Ren Wen,
Rong-Rong Huang, Eijun Itakura, Frank Luo, Scott W.
Binder
12. Molecular Diagnosis of Micrometastasis in the Sentinel 221
Lymph Node
Hiroya Takeuchi, Robert A. Wascher, Christine Kuo,
Roderick R. Turner, Dave S.B. Hoon
13. Credentialing of Nuclear Medicine Physicians, 25 3
Surgeons, and Pathologists as a Multidisciplinary Team
for Selective Sentinel Lymphadenectomy
Masaki Kitajima, Yuko Kitagawa, Hirofumi Fujii, Makio
Mukai, Atsushi Kubo
14. Selective Sentinel Lymphadenectomy: Progress to Date 269
and Prospects for the Future
John F. Thompson, Roger F. Uren, Richard A. Scolyer,
Jonathan R. Stretch
Index 289
PREFACE
Lymph node (LN) status is the most important prognostic indicator for the
clinical outcome of patients in human solid cancer. Recent developments in
sentinel lymph node (SLN) concept and technology have resulted in the
application of this revolutionary approach to determine if cancer has
metastasized to the regional nodal basin. The underlying thesis in solid
cancer biology is that metastasis generally starts in an orderly progression,
often spreading through the lymphatic channels to the SLNs, the first lymph
node or nodes to receive the metastatic cancer cells. Thus, the logical
approach is to harvest that specific SLN for thorough analysis. Because a
tumor-free SLN is usually associated with a negative residual LN basin, a
negative SLN is an excellent indication that micrometastasis has not occurred
in the regional LNs. When the SLN is involved, it is unknown whether or not
metastasis is limited only to the SLN or if the disease has spread to the
remainder of the nodal basin. For this reason, if an SLN is positive, a
complete LN dissection is recommended. Therefore, selective sentinel
lymphadenectomy (SSL) should be considered as a staging procedure so that
patients with negative SLNs (about 80%) may be spared an extensive LN
dissection.
Malignant melanoma has been proven to be the most ideal tumor model to
study the role of SLN. Subsequently, SSL has been applied to breast cancer,
colon cancer, and other types of solid cancer. The multidisciplinary approach
encompassing the surgeon, nuclear medicine physician, and pathologist is the
key to such a successful procedure. Such a team can be readily formed with
appropriate training. Beyond the technical aspects of harvesting the SLN, the
implication of micrometastasis remains to be defined. Follow-up of
melanoma and breast cancer patients after SSL is crucial. Therefore, for both
melanoma and breast cancer, ongoing clinical trials are in progress to
determine the biological and clinical significance of SLNs. Although the
concept of SLN is viable in other types of cancer, such as gastrointestinal,
lung, urologic, gynecologic and head & neck cancers, the technical aspects of
the procedure need to be perfected and verified.
viii
The most exciting possibility of SSL is that it will lead to early diagnosis
of micrometastasis in regional LNs. Early diagnosis makes it useful as a
clinical staging procedure, and opens up new opportunities to study
micrometastasis and its evolution within the SLNs. New molecular and
genetic tools may be used to dissect the mechanisms of lymphatic and
hematogenous routes of metastasis. Multifaceted aspects of micrometastasis
including differentiation of different clones with respect to the primary tumor,
the acquisition of adhesion molecules, host interaction with the microscopic
tumor, and so forth will shed new light on the biology and mechanism of early
metastasis. If such mechanisms can be understood, new therapeutic advances
may be developed to prevent the process of micrometastasis. In addition,
clinical trials can be developed for high risk patients following definitive
surgical resection, rather than using it in treating large tumor burdens, such as
in Stage IV disease. SSL is a standard staging procedure for patients with
melanoma and is rapidly evolving into a standard staging procedure for breast
cancer as well. The techniques of harvesting SLNs are being developed in
other solid cancers as mentioned above.
We are extremely delighted to be the editors of this exciting book on
Selective Sentinel Lymphadenectomy for Human Solid Cancer. The historical
background and rationale of SSL will be summarized by Dr. Wong. The role
of lymphoscintigraphy for SSL will be addressed by Dr. Uren and his
associates. SSL for cutaneous cancer, including malignant melanoma, Merkel
cell carcinoma, and squamous cell carcinoma of the skin will be discussed by
Dr. Leong. The role of SSL for breast cancer will be updated by Dr. Cox and
his team. Dr. Saha and his group will show how the techniques of SSL apply
to colorectal cancer. Dr. Kitagawa and his associates will present their
extensive experience on SSL for upper gastrointestinal cancer. Exciting
application of SSL in lung cancer will be summarized by Dr. Liptay,
genitourinary cancer by Dr. Cabanas, and gynecological cancer by Dr.
Levenback. SSL has been utilized to head and neck squamous carcinoma and
this will be addressed by Dr. Werner. Pathological evaluation of SLNs will
be discussed by Dr. Cochran and his co-workers. The application of
molecular detection of micrometastasis of SLNs will be presented by Dr.
Hoon and his group. Multidisciplinary approach in the performance of SSL
will be discussed by Dr. Kitajima and his colleagues. The past, present, and
future of SSL will be addressed by Dr. Thompson and his associates.
ix
SSL allows us to identify lymph nodes with micrometastasis in a more
selective fashion. With the advances in molecular, genetic, and
immunological techniques, micrometastasis as detected by SSL can finally be
studied in its detail. When mechanisms of early metastasis are fully
understood, potential treatment modalities can be developed to either prevent
or eliminate micrometastasis in the early stage of lymph node involvement.
Stanley P. L. Leong, MD, FACS
Department of Surgery
UCSF Comprehensive Cancer Center
San Francisco, California 94143-1674
Yuko Kitagawa, MD, FACS
Department of Surgery
Keio University School of Medicine
Shinjuku-ky Tokyo, Japan
Masaki Kitajima, MD, FACS
Department of Surgery
Keio University School of Medicine
Shinjuku-ky Tokyo, Japan