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Experiencia en 125 casos" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tumour staging with an accurate evaluation of lymph node metastases is the most important prognostic factor in colorectal cancer (CRC). Patients have different survival rates based on TNM staging. Thus, the early stages (<span class="elsevierStyleSmallCaps">I</span> and <span class="elsevierStyleSmallCaps">II</span>) have survival rates between 82% and 93%, while survival decreases to 59% at 5 years in the presence of lymph node metastases (stage <span class="elsevierStyleSmallCaps">III</span>).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Fifty per cent of patients with CRC are diagnosed in the early stages without lymph node metastases and are being treated with potentially curative surgery. However, 20%–30% will die of their disease within 5 years.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This high percentage can be explained in part by the understaging of these patients due to an insufficient lymph node yield. We should note that chemotherapy in patients with lymph node infiltration has improved the survival, decreasing mortality by more than 30%.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The American Joint Committee on Cancer (AJCC) recommends studying at least 12 lymph nodes for correct staging.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Intensive study techniques to determine lymph node involvement are being advanced to improve the staging of CRC patients. However, the large number of resources needed to implement such studies in all lymph nodes makes them unfeasible.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The sentinel lymph node (SLN) concept is based on the way tumour cells spread <span class="elsevierStyleItalic">via</span> the lymphatic drainage from the primary tumour site to the first lymph node. Thus, the SLN is at greatest risk for metastasis and identifying it can better predict the nodal status of the patient. SLN identification allows the use of intensive study techniques more efficiently. The main aim of this study is to determine the efficacy of the <span class="elsevierStyleItalic">ex vivo</span> SLN dye technique in colon cancer (CC) staging.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This is a cross-sectional, crossover, single-centre study to determine the efficacy of SLN study in the staging of CC. One hundred twenty five patients from the Txagorritxu-Álava University Hospital were included in the study. A prospective cohort was selected between September 2009 and December 2011; it included all cases without randomisation. Diagnosis was made using colonoscopy, abdominal and pelvic CT scans and chest radiography. The SLN technique was performed by 5 surgeons with previous experience with using the technique for CC (up to 10 cases per surgeon). Patient inclusion criteria were as follows: CC, elective surgery, curative surgery, and being over 18 years of age. The exclusion criteria included Stage <span class="elsevierStyleSmallCaps">IV</span>cancer, urgent and palliative surgery, and rectal cancer.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Additionally, a comparative study with a control sample was conducted in which only a conventional pathologic examination was performed (single haematoxylin–eosin section). This group comprised 170 patients consecutively operated on between June 2006 and February 2009. All of the patients were operated on by the same surgeons and met the same inclusion criteria as those in the SLN study. The pathology examination was not performed by the same pathologists who studied specimens in the SLN technique group. The information required for this group of patients was obtained <span class="elsevierStyleItalic">via</span> medical records review.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The primary endpoint was a staging change resulting from the SLN study. Other variables were the age and sex of the patient, the location and T and N tumour classification, the total number of lymph nodes and number of SLNs, the number of infiltrated lymph nodes according to the conventional study and the SLN study, and the type of involvement.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The procedures comply with the principles of the Declaration of Helsinki of 1964, as amended in 2008 in Seoul. This study was approved by the Clinical Research Ethics Committee of the Txagorritxu-Álava University Hospital.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Sentinel Lymph Node Identification</span><p id="par0045" class="elsevierStylePara elsevierViewall">SLN identification was performed <span class="elsevierStyleItalic">ex vivo</span> after resection of the surgical specimen. We infiltrated 1–2<span class="elsevierStyleHsp" style=""></span>mL of methylene blue peritumourally and into the subserosa, depending on the tumour size. We performed a massage for 5–10<span class="elsevierStyleHsp" style=""></span>min to spread the dye through the lymph channels and dye the lymph nodes. Mesocolon dissection started near the tumour, following the dye-stained paths. We considered the SLNs to be the first 1–4 dyed lymph nodes and those through which a dyed lymphatic duct directly and clearly reaches the lymph node without becoming dyed itself.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Intensive Study of the Sentinel Lymph Node</span><p id="par0050" class="elsevierStylePara elsevierViewall">Two-mm thick sections were prepared, and a single section was prepared for lymph nodes under 5<span class="elsevierStyleHsp" style=""></span>mm. After fixation in 4% buffered formalin for 24<span class="elsevierStyleHsp" style=""></span>h, six 4-μm sections were prepared. Haematoxylin–eosin and immunohistochemistry (cytokeratin monoclonal antibody CAM 5.2) staining techniques were sequentially applied, so that three sections were studied with each technique.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Interpretation of the Anatomopathological Findings</span><p id="par0055" class="elsevierStylePara elsevierViewall">According to the AJCC<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> classification, we considered <span class="elsevierStyleItalic">metastasis</span> an involvement greater than 2<span class="elsevierStyleHsp" style=""></span>mm, <span class="elsevierStyleItalic">micro-metastases</span> involvements from 2<span class="elsevierStyleHsp" style=""></span>mm to 0.2<span class="elsevierStyleHsp" style=""></span>mm, and <span class="elsevierStyleItalic">tumour groups of colonies and isolated cells</span> those equal or less than 0.2<span class="elsevierStyleHsp" style=""></span>mm. The presence of metastases and micro-metastases modified staging, as pN1 and pN1mi was considered, respectively. Lesions 0.2<span class="elsevierStyleHsp" style=""></span>mm or smaller did not change staging and were considered pN0 (i+). The remaining nodes were conventionally studied using single section and haematoxylin–eosin staining.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical Analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Quantitative variables were described by means and standard deviations, and categorical variables were described as frequencies and percentages. The similarity of the samples was checked using Student's t-test and the chi-squared test. The latter test was also used to compare the proportion of infiltrated lymph nodes and overstaging. The validity of the diagnostic test was analysed to obtain sensitivity and specificity and confidence intervals and compare them to those of the gold standard (conventional lymph node study). Statistical significance was set at P>.05.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Group Studied Using the Sentinel Lymph Node Technique</span><p id="par0065" class="elsevierStylePara elsevierViewall">SLN identification was accomplished in 122 (97.6%) of the 125 patients, and technique failure was determined in 2.4% of the cases. The SLN study detected infiltration in 36 (29.5%) of the 122 patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). SLN predicted total lymph node status in 115 of the 122 cases, so that test accuracy was 93.4% (95% CI: 89.1%–97.8%), sensitivity was 83.3% (95% CI: 72.1%–94.6%), and specificity was 98.8% (95% CI: 96.3%–100%).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The SLN study detected lymph node metastases in 18 of the 25 patients who showed metastases in the conventional study (lymph node +) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Thus, 7 of 122 patients had no SLN metastases and had at least one other affected lymph node. Therefore, the false negative rate was 5.7%.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The SLN study detected lymph node metastases in 18 (18.6%) of the 97 patients who showed no metastases in the conventional study (lymph node −; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). The intensive study of the sentinel lymph node in 18 patients detected metastases in 12, micro-metastases in 5 and isolated tumour cells (ITC) in one patient. Thus, an upstaging in this group was 18.6% using the SLN technique.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Comparison between the sentinel lymph node technique group and the conventional study group.</p><p id="par0085" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the homogeneity of the two groups compared, where the surgical approach is the only difference between the two samples. In the <span class="elsevierStyleItalic">control group</span> (conventionally studied), we detected lymph node metastases in 33 (19.4%) of 170 patients (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>), while in the <span class="elsevierStyleItalic">SLN study group</span>, we detected lymph node infiltration in 42 (33.6%) of 125 patients. That is, the SLN study found 14.2% more patients with lymph node infiltration, a difference that was statistically significant. Therefore, the <span class="elsevierStyleItalic">upstaging</span> achieved by the SLN technique was 14.2%. <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows that in the group studied with the SLN technique, the SLN study alone detected lymph node involvement in 36 (29.5%) of the 125 patients. This represents 10% more patients with lymph node infiltration compared to the control group (19.4%). In contrast, the conventional study detected an almost identical percentage of patients with lymph node metastases in the 2 groups (19.4% and 20%, respectively).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">A mean of 20.5 lymph nodes (range: 3–58) were extracted in the SLN study group, while the mean was 15.5 nodes in the control group (range: 0–62), a difference that was statistically significant (<span class="elsevierStyleItalic">P</span><.001). <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> shows that in the <span class="elsevierStyleItalic">SLN study group</span>, lymph node infiltration was detected in 169 (6.6%) of 2559 nodes examined, while in the <span class="elsevierStyleItalic">control group</span>, we detected metastases in 131 (4.9%) of the 2630 nodes found. Thus, a higher percentage of infiltrated lymph nodes were detected in the SLN study group than in the conventional study used for the control group, and the difference was statistically significant (<span class="elsevierStyleItalic">P</span>=.012). The conventional study detected a similar percentage of infiltrated lymph nodes for the 2 groups (4.9% and 5.1%).</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">In addition, <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> shows the difference in lymph node involvement in the SLN study group. The study of 353 SLNs detected more lymph node involvement than the conventional study of 2206 non-sentinel lymph nodes, a difference that was statistically significant (<span class="elsevierStyleItalic">P</span><.001).</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">Lymph node involvement is the single most important prognostic factor in CRC. Studies<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6–9</span></a> show that survival increased when the number of studied lymph nodes increased, especially when those lymph nodes were negative. Proper staging of CRC includes identifying at least 12 lymph nodes; a smaller number may assume understaging and lead to a poorer prognosis, as the patient will not benefit from adjuvant therapy.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The number of lymph nodes detected in the surgical specimen depends on multiple factors, including pathologic study limitations. The intrinsic difficulty of the technique is added to the fact that 70% of infiltrated lymph nodes are smaller than 5<span class="elsevierStyleHsp" style=""></span>mm and are likely not to be detected.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Furthermore, the study by single section allows the analysis of only 1% of lymph node tissue, so that small tumour lesions with a subcapsular location can remain undetected.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The SLN technique identifies a lymph node that can reliably predict the patient's nodal status, allowing them to be studied using intensive techniques without significant resource consumption. Numerous studies<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,11–14</span></a> offer overstaging results of 10%–20% with the use of immunohistochemical and molecular biology (reverse transcriptase polymerase chain reaction [RT-PCR]) techniques. Performing multiple sections improves staging up to 9%.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The use of radioisotopes is standard in breast cancer and melanoma. However, the use of a dye has been reported as a good alternative.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> From our point of view, the dye technique is simpler because it does not require collaboration with other services, such as nuclear medicine and gastroenterology. Furthermore, we avoid the risks of a colonoscopy, which is necessary to infiltrate the radiotracer. Therefore, and given the absence of studies confirming that the use of radiotracers achieves better results, we believe that the use of dyes such as methylene blue is the best SLN study technique in CRC.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Aberrant lymphatic drainage and improved lymphatic circulation when the surgical specimen has not yet been resected are arguments in favour of the <span class="elsevierStyleItalic">in vivo</span> technique. The first assumes the existence of nodal metastases outside the boundaries of standard resection. However, the frequency of such metastases is low, ranging between 2% and 8%, and quite a few groups cannot even detect it.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17,18</span></a> Regarding lymphatic drainage in the excised surgical specimen, experience with breast cancer and melanoma confirms that massaging the infiltrated area allows proper dye spread <span class="elsevierStyleItalic">via</span> the lymphatic circulation.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> In addition, surgical resection disrupts the neurological mechanism that regulates the constriction of the lymphatic channels, thus facilitating lymphatic circulation.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In 2001, Wong et al.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> published the first large series of patients studied <span class="elsevierStyleItalic">ex vivo</span> using the SLN technique. The results obtained in this study and in others published later are similar to those achieved when using the <span class="elsevierStyleItalic">in vivo</span> technique.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20–23</span></a> As arguments for the <span class="elsevierStyleItalic">ex vivo</span> technique, we could say that it prevents the risk of perforation and the spread of tumour cells caused by tumour manipulation and prevents anaphylactic reaction to contrast, without modifying the surgical procedure, and it allows the procedure to be performed by a surgeon who is not directly involved in the specific intervention, thus requiring a shorter learning curve. Moreover, from our perspective, the technique's main advantage is its simplicity, which is especially important for large tumours or those localised in the rectum and for laparoscopic surgery. Thus, groups that commonly use the <span class="elsevierStyleItalic">in vivo</span> technique can use the <span class="elsevierStyleItalic">ex vivo</span> procedure in the above-mentioned cases.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24,25</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">SLN identification rate</span> varies between 58% and 100% with most authors<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20–27</span></a> reporting values above 95%, while the <span class="elsevierStyleItalic">false negative rate</span> is between 0% and 10%. These results depend mainly on the experience of the team performing the procedure and the amount of infiltrated dye.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> The type of technique, either <span class="elsevierStyleItalic">in vivo</span> or <span class="elsevierStyleItalic">ex vivo</span> and using either a radiotracer or dye, does not seem to influence these results.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20,28</span></a> In breast cancer, <span class="elsevierStyleItalic">validation</span> parameters recommend at least a 95% SLN identification rate and a 5% or lower false negative rate.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> The learning curve for the SLN technique in CRC is unknown, but it appears to be lower than in breast cancer, which requires 5–10 cases per surgeon.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">30,31</span></a> Our study was conducted by surgeons with previous experience of 10 cases, and we achieved SLN identification in 98% of cases and a false negative rate of almost 5%.</p><p id="par0135" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Upstaging</span> in our study was 14% compared with the conventionally studied control group. This value is comparable to those reported by groups with more experience.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11–14,27</span></a> The conventional pathological study detected a similar percentage of infiltrated lymph nodes in the 2 groups (4.9% and 5.1%). Therefore, the upstaging achieved in the SLN study group can be attributed to the SLN technique. We emphasise that the SLN study's aim is not to change surgery and avoid lymphadenectomy. Thus, we managed to recover the cases responsible for the false negative rate of the conventional study. The combined pathological study benefits from the upstaging of the SLN study, while the conventional study addresses false negatives.</p><p id="par0140" class="elsevierStylePara elsevierViewall">We want to remark that the conventional study of the 2 groups detected a similar percentage of infiltrated nodes, so that the greatest total number of infiltrated lymph nodes detected in the SLN group can be attributed to the SLN technique (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>).</p><p id="par0145" class="elsevierStylePara elsevierViewall">We end by stating that the predictive value of lymph node micro-metastases in CC survival is unclear, and studies with longer follow-ups of these patients are needed.<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">32,33</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">We <span class="elsevierStyleItalic">conclude</span> that the SLN technique with methylene blue performed <span class="elsevierStyleItalic">ex vivo</span> predicts nodal status in patients with CC. The SLN technique achieves upstaging and classifies as stage <span class="elsevierStyleSmallCaps">III,</span> patients who conventional study would have classified as Stage 0, I and <span class="elsevierStyleSmallCaps">II</span>. This increase in staging allows these patients access to a chemotherapy treatment that could improve their prognosis.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflict of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres296761" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Materials and methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec280382" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres296760" "titulo" => array:5 [ 0 => "Resumen" 1 => "Introducción" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec280383" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Sentinel Lymph Node Identification" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Intensive Study of the Sentinel Lymph Node" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Interpretation of the Anatomopathological Findings" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical Analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Group Studied Using the Sentinel Lymph Node Technique" ] ] ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-07-31" "fechaAceptado" => "2012-11-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec280382" "palabras" => array:5 [ 0 => "Sentinel lymph node" 1 => "<span class="elsevierStyleItalic">Ex vivo</span> technique" 2 => "Methylene blue" 3 => "Colon cancer" 4 => "Upstaging" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec280383" "palabras" => array:5 [ 0 => "Ganglio centinela" 1 => "Técnica <span class="elsevierStyleItalic">ex vivo</span>" 2 => "Azul de metileno" 3 => "Cáncer de colon" 4 => "Supraestadificación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The level of lymph node involvement is the most important factor in staging colorectal cancer without metastasis. Sentinel lymph node mapping identifies the node(s) that most accurately reflect the lymph node status of patients, and intensive techniques that improve staging can be focused on these nodes. The aim of this study was to assess the efficacy of <span class="elsevierStyleItalic">ex vivo</span> sentinel lymph node mapping in the staging of colon cancer.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective study was conducted on 125 patients from the Álava-Txagorritxu University Hospital Health Region (Álava), who were diagnosed prior to surgery with colon cancer without distant metastasis from September 2009 to December 2011. <span class="elsevierStyleItalic">Ex vivo</span> sentinel lymph node mapping with methylene blue was use in these patients to study the sentinel nodes with multiple slices using immunohistochemical techniques and haematoxylin–eosin staining. A comparative study was also performed based on a control group of 170 patients staged with conventional techniques, and involving a single slice and haematoxylin–eosin staining.</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The sentinel lymph node identification rate was 98%, with 5.6% false negatives. Upstaging occurred in 14.2% of cases compared to the group studied using conventional techniques (<span class="elsevierStyleItalic">P</span>=.006).</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Ex vivo</span> sentinel lymph node mapping with methylene blue accurately reflects the lymph node status of patients with colon cancer. This approach upstages patients classified as stages <span class="elsevierStyleSmallCaps">i</span> and <span class="elsevierStyleSmallCaps">ii</span> by conventional techniques to stage <span class="elsevierStyleSmallCaps">iii</span>, indicating chemotherapy that may improve their prognosis.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El estudio de los ganglios linfáticos supone el factor pronóstico más importante en el cáncer colorrectal sin metástasis. La técnica del ganglio centinela identifica el ganglio que mejor predice el estado ganglionar de un paciente y permite realizar en él técnicas de estudio intensivo que mejoran la estadificación. El objetivo del trabajo es estudiar la eficacia de la técnica del ganglio centinela en la estadificación del cáncer de colon.</p> <span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo con 125 pacientes diagnosticados preoperatoriamente de cáncer de colon sin metástasis a distancia desde septiembre de 2009 hasta diciembre de 2011 en el Hospital Universitario de Álava-Txagorritxu en Álava. Realizamos la técnica del ganglio centinela <span class="elsevierStyleItalic">ex vivo</span> y con azul de metileno. El ganglio centinela se estudió realizando secciones múltiples y técnicas de inmunohistoquímica, además de hematoxilina-eosina. Realizamos un estudio comparativo con un grupo control con 170 pacientes estudiado de forma convencional mediante sección única y tinción de hematoxilina-eosina.</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Identificamos el ganglio centinela en el 98% de los casos, con una tasa de falsos negativos del 5,6%. La supraestadificación lograda en el grupo con estudio del ganglio centinela se encuentra en el 14,2% con respecto al grupo estudiado convencionalmente (p = 0,006).</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El estudio del ganglio centinela realizado <span class="elsevierStyleItalic">ex vivo</span> y con azul de metileno predice el estado ganglionar de los pacientes con cáncer de colon. Esta técnica supraestadifica, pasando al estadio <span class="elsevierStyleSmallCaps">iii</span> a pacientes que el estudio convencional determinaba como estadios <span class="elsevierStyleSmallCaps">i</span> y <span class="elsevierStyleSmallCaps">ii</span>, permitiendo que accedan a un tratamiento quimioterápico que podría mejorar su pronóstico.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Sardón Ramos JD, Errasti Alustiza J, Campo Cimarras E, Cermeño Toral B, Romeo Ramírez JA, Sáenz de Ugarte Sobrón J, et al. Técnica del ganglio centinela en el cáncer de colon. Experiencia en 125 casos. Cir Esp. 2013;91:366–371.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patients N + \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patients N − \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sentinel lymph node + \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sentinel lymph node − \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">122 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab432772.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Group Studied Using the Sentinel Lymph Node Technique. Analysis of Test Validity.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Nonsentinel lymph nodes (conventional study)</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">lymph nodes + \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">lymph nodes − \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sentinel lymph nodes (intensive study)</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SLN + \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SLN − \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Total</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">122 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab432773.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Group Studied Using the Sentinel Lymph Node Technique. Distribution of Patients by Lymph Node Anatomopathological Results According to Technique: Conventional Study <span class="elsevierStyleItalic">vs</span> Intensive Study (SLN Technique).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Sentinel lymph node \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Conventional pathological study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Difference (<span class="elsevierStyleItalic">P</span>) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">No.</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">125 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">170 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67.54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69.19<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.181 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 (64.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">106 (62.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.772 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (36.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (37.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Location</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right colon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 (36.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78 (45.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.090 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Transverse colon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (6.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Descending colon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (10.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (4.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sigma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 (46.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73 (42.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Resection type</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right hemicolectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (37.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 (49.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.101 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left hemicolectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (9.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (4.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sigmoidectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 (44.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 (38.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total colectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (8.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (7.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Surgical approach</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Laparoscopy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (56.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76 (44.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.040 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Laparotomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54 (43.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94 (55.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">T classification</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tis<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>T1<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>T2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 (32.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (37.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.390 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>T3<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>T4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (67.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">106 (62.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">CEA</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5806 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6121 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.832 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab432770.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Patient Features of the Sentinel Lymph Node Study Group and the Control Group.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Pathological study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patients with nodal involvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Percentage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Control group (n=170) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Conventional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.006 (14.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sentinel lymph node technique group (n=125) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Combined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sentinel lymph node</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.059 (10.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Conventional</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab432774.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Comparison of Patients With Lymph Node Infiltration According to the Pathological Examination Type Performed (Control Group/SLN Technique Group).</p>" ] ] 4 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total number of lymph nodes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Number of infiltrated lymph nodes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Percentage (%) of infiltrated lymph nodes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Conventional study control group (170 patients)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2630 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">131 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Group with sentinel lymph node biopsy (125 patients)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2559 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">169 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-sentinel lymph nodes (conventional technique) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2206 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">113 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sentinel lymph node (SLN technique) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">353 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56/65<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.86/18.4<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab432771.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Includes isolated tumour cells.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Comparison of Lymph Node Metastatic Infiltration According to the Pathological Examination Type Used (Control Group/SLN Technique Group).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.B. 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2024 September | 38 | 2 | 40 |
2024 August | 54 | 4 | 58 |
2024 July | 30 | 8 | 38 |
2024 June | 37 | 5 | 42 |
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2024 February | 81 | 2 | 83 |
2024 January | 51 | 7 | 58 |
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2023 November | 57 | 2 | 59 |
2023 October | 98 | 7 | 105 |
2023 September | 45 | 6 | 51 |
2023 August | 63 | 8 | 71 |
2023 July | 42 | 10 | 52 |
2023 June | 74 | 1 | 75 |
2023 May | 64 | 3 | 67 |
2023 April | 79 | 5 | 84 |
2023 March | 63 | 7 | 70 |
2023 February | 47 | 9 | 56 |
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2021 July | 53 | 11 | 64 |
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2021 March | 42 | 15 | 57 |
2021 February | 29 | 10 | 39 |
2021 January | 33 | 10 | 43 |
2020 December | 16 | 8 | 24 |
2020 November | 24 | 8 | 32 |
2020 October | 26 | 9 | 35 |
2020 September | 22 | 9 | 31 |
2020 August | 14 | 10 | 24 |
2020 July | 24 | 19 | 43 |
2020 June | 24 | 9 | 33 |
2020 May | 19 | 12 | 31 |
2020 April | 13 | 6 | 19 |
2020 March | 10 | 14 | 24 |
2020 February | 15 | 8 | 23 |
2020 January | 11 | 4 | 15 |
2019 December | 22 | 11 | 33 |
2019 November | 17 | 7 | 24 |
2019 October | 16 | 8 | 24 |
2019 September | 17 | 16 | 33 |
2019 August | 9 | 1 | 10 |
2019 July | 15 | 15 | 30 |
2019 June | 25 | 15 | 40 |
2019 May | 103 | 53 | 156 |
2019 April | 34 | 18 | 52 |
2019 March | 7 | 2 | 9 |
2019 February | 15 | 8 | 23 |
2019 January | 6 | 5 | 11 |
2018 December | 8 | 3 | 11 |
2018 November | 10 | 0 | 10 |
2018 October | 5 | 7 | 12 |
2018 September | 6 | 1 | 7 |
2018 August | 19 | 6 | 25 |
2018 July | 5 | 1 | 6 |
2018 June | 8 | 1 | 9 |
2018 May | 9 | 1 | 10 |
2018 April | 15 | 1 | 16 |
2018 March | 2 | 0 | 2 |
2018 February | 7 | 2 | 9 |
2018 January | 2 | 1 | 3 |
2017 December | 7 | 1 | 8 |
2017 November | 5 | 2 | 7 |
2017 October | 15 | 1 | 16 |
2017 September | 9 | 2 | 11 |
2017 August | 21 | 2 | 23 |
2017 July | 18 | 0 | 18 |
2017 June | 25 | 4 | 29 |
2017 May | 18 | 1 | 19 |
2017 April | 19 | 3 | 22 |
2017 March | 12 | 52 | 64 |
2017 February | 20 | 0 | 20 |
2017 January | 14 | 0 | 14 |
2016 December | 12 | 8 | 20 |
2016 November | 29 | 2 | 31 |
2016 October | 42 | 10 | 52 |
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2016 August | 27 | 7 | 34 |
2016 July | 22 | 1 | 23 |
2016 June | 28 | 10 | 38 |
2016 May | 21 | 10 | 31 |
2016 April | 16 | 8 | 24 |
2016 March | 16 | 21 | 37 |
2016 February | 16 | 10 | 26 |
2016 January | 6 | 8 | 14 |
2015 December | 15 | 3 | 18 |
2015 November | 25 | 7 | 32 |
2015 October | 21 | 6 | 27 |
2015 September | 26 | 10 | 36 |
2015 August | 9 | 5 | 14 |
2015 July | 14 | 8 | 22 |
2015 June | 4 | 2 | 6 |
2015 May | 11 | 1 | 12 |
2015 April | 16 | 6 | 22 |
2015 March | 11 | 5 | 16 |
2015 February | 9 | 5 | 14 |
2015 January | 21 | 5 | 26 |
2014 December | 37 | 9 | 46 |
2014 November | 30 | 3 | 33 |
2014 October | 16 | 6 | 22 |
2014 September | 17 | 6 | 23 |
2014 August | 22 | 6 | 28 |
2014 July | 17 | 2 | 19 |
2014 June | 16 | 7 | 23 |
2014 May | 17 | 3 | 20 |
2014 April | 13 | 6 | 19 |
2014 March | 9 | 5 | 14 |
2014 February | 12 | 5 | 17 |
2014 January | 12 | 5 | 17 |
2013 December | 13 | 3 | 16 |