Sentinel lymph node in prostate cancer patients – preliminary experience
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Radosław Starownik, Robert Klijer, Krzysztof Bar, Waldemar Białek, Marek Urban, Beata Chrapko

Katedra i Klinika Urologii i Onkologii Urologicznej AM w Lublinie
Zakład Medycyny Nuklearnej AM w Lublinie

summary

Introduction.

Surgical removal of the prostate and regional lymph nodes is a common treatment for early stage prostate cancer. Lymphatic spread of the prostate is disseminated, it is not surprising that extended lymph nodes dissection detect more lymph node metastases than standard. In 1999 Wawroshek et al. described technique of preoperative lymphoscintigraphy with intraoperative γ probe guide SLN detection. Sentinel lymph node (SLN) is the first lymph node to which cancer cells are likely to spread from the primary tumor.

Objectives.

We describe the concept of sentinel lymph node in prostate cancer patients’, methods and preliminary experience.

Materials and methods.

Twelve patients with T1c-T2 stage prostate cancer (56-71 years old) were enrolled into this study. All of them underwent open radical retropubic prostatectomy in Department of Urology and Urological Oncology of Medical School in Lublin. Following obtaining informed consent, one day before lymphadenectomy about 100 MBq 99m technetium nanocoloid were applied transrectally in each prostate lobe under ultrasound guidance. Total injected volume was 2 ml. Later preoperative lymphoscintigraphy was performed, showed lymphatic drainage and sentinel lymph node, the first lymph node to which nanocoloid was spread. During the operation lymph nodes radioactivity was measured by γ probe. Once the SLNs were located and removed. The pathologist exactly examined SLNs using hematoxylin and eosin staining.

Results.

With the exception of one patient the SLNs were located in 11 (91.6%) patients using preoperative lymphoscintigraphy and intraoperatively. The strong correlation between images from lymphoscintigraphy and localizations of SLNs detected intraoperatively with γ probe was confirmed. In 5 patients (45.4%) metastases in SLNs were revealed.

Conclusions.

Conception of sentinel lymph node in prostate cancer patients is reasonable. This method may be applicable in precise assessment of sentinel lymph node prostate cancer patients and should be implemented into clinical practice. <