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Methylene blue‐assisted lymph node dissection in combination with ex vivo sentinel lymph node mapping in gastric cancer
Author(s) -
Märkl Bruno,
Wünsch Katharina,
Hebick KaiUwe,
Anthuber Matthias,
Probst Andreas,
Arnholdt Hans Martin,
Spatz Hanno
Publication year - 2009
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2009.03243.x
Subject(s) - ex vivo , medicine , sentinel lymph node , lymph node , lymph , cancer , dissection (medical) , methylene blue , stage (stratigraphy) , sentinel node , in vivo , radiology , retrospective cohort study , pathology , nuclear medicine , biology , breast cancer , microbiology and biotechnology , photocatalysis , catalysis , paleontology , biochemistry
Aims: Lymph node (LN) stage is still the strongest prognostic marker in potentially curable gastric cancer. Accuracy of histopathological lymph node assessment depends on the number of investigated LNs and detection rate of metastases and micrometastases. The aim was to perform a feasibility study employing intra‐arterial methylene blue injection – a novel method to improve LN harvest – and ex vivo sentinel LN mapping. Methods and results: A total of 33 cases were enrolled, including 14 retrospective cases that served as a control group. The methylene group showed a highly significant improved mean LN harvest compared with unstained cases, with 38 ± 14 versus 21 ± 10 LNs ( P < 0.001), respectively. The detection rate of ex vivo sentinel mapping was 88%. No skip metastases occurred. Conclusion: Both techniques have the potential to improve the accuracy of histopathological LN staging and can be combined successfully.