Editorial article
Sentinel node in lung cancer
Ganglio centinela en el cáncer pulmonar
a Department of Nuclear Medicine, Netherlands Cancer Institute, Ámsterdam, The Netherlands
b Interventional Molecular Imaging Laboratory and Nuclear Medicine Section, Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
c Nuclear Medicine Department, University Hospital Clinic Barcelona, Barcelona, Spain
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Valdés Olmos, Sergi Vidal-Sicart" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Renato A." "apellidos" => "Valdés Olmos" "email" => array:1 [ 0 => "R.A.Valdes_Olmos@lumc.nl" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Sergi" "apellidos" => "Vidal-Sicart" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Nuclear Medicine, Netherlands Cancer Institute, Ámsterdam, The Netherlands" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Interventional Molecular Imaging Laboratory and Nuclear Medicine Section, Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Nuclear Medicine Department, University Hospital Clinic Barcelona, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ganglio centinela en el cáncer pulmonar" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Almost 25 years after the introduction of the sentinel node biopsy in the cutaneous melanoma,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> the procedure has gone on to be validated for other malignant tumours which affect organs such as the breast, penis and vulva, which are characterised by presenting fundamentally superficial drainage. In recent years, the sentinel node biopsy has also been the object of studies in malignant tumours with complex drainage in regions such as the head and neck, pelvis, abdomen and thorax.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> Recently, Guidoccio et al.,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> critically reviewing the sentinel node biopsy, emphasised that, despite the metastasis pattern in non-small cell lung cancer (NSCLC) being predictable insofar as its lymphatic spread instead of haematogenous, the ordered progression paradigm of the metastasis that characterises the concept of the lymphatic sentinel node was difficult in this type of lung cancer due to data showing that in 5% of cases, the lymph originating in the pulmonary parenchyma drains to nodes of the supraclavicular region or directly to the thoracic duct. In addition, in the 20–35% of cases direct drainage towards the mediastinal lymph nodes without intermediate stations is observed. Lymphatic drainage depends to a large extent on the location of the primary tumour and, for example, lesions situated in the upper part of the lung can drain towards the paratracheal nodes and even the ipsilateral supraclavicular lymph nodes, while for tumours in the lower areas, a possible spread via the subcarinal lymph nodes or even those situated in the pulmonary ligament must be taken into account.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Given this variability in drainage, an ideal protocol to tackle the sentinel node in lung cancer should cover the classic procedure principles described by Morton in 1992.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> These recognise the need to have a preoperative image to determine the lymph node at risk of metastasis stations and, at the same time, serve to guide the surgeons to go in search of the sentinel node in those regions during the surgical act. Throughout the first decades of the sentinel node biopsy, the preoperative image was supplied by the lympho-gammagraphy, with early and late obtained sequential planar images after the injection of a radiotracer. This lymphatic mapping constituted the first route map for nuclear and surgical doctors in the localisation of the sentinel node, which served, in addition, as a base to consolidate both the effectiveness and reliability of the procedure. When the procedure was extended to other malignant tumours with more complex lymphatic drainage, the incorporation of the SPECT/TC helped to solve some limitations of the preoperative planar image. By means of the correction of the attenuation of tissues obtained with the SPECT/TC, it was possible to detect sentinel nodes of deep localisation or weak capture. In the same way, the route map for surgeons was perfected, because it was now possible to show anatomical reference points regarding the locations of the sentinel node recognised intraoperatively via both 2D and 3D visualisation. This approach has been particularly successful in urological cancers, gynaecological cancers, and cancers of the oral cavity.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However, in a limited number of malignant tumours, the incorporation of the lymphatic mapping preoperative image is problematic, above all due to limitations in the administration of the radioactive tracer. Such is the case of neoplasias located in the digestive tube and also the case of lung cancer. This has generated procedure adaptations, limiting it solely to the intraoperative technique, as is evaluated in this issue of Medicina Clínica, for lung cancer<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> in a study which includes 48 patients with NSCLC, who received a dosage of 9.25<span class="elsevierStyleHsp" style=""></span>MBq of a radiocolloid injected in the 4 quadrants of the tumour, with a minimum time of 10<span class="elsevierStyleHsp" style=""></span>min to facilitate the migration of the radiotracer towards the lymphatic nodes and the search for them using a manual gamma radiation detector. The sentinel node procedure was part of a surgical act which included the standardised resection of the primary tumour, in addition to the mediastinal, peribronchial and visible hilar lymph nodes. All nodes presenting radioactivity 3 times greater than the patient's baseline value were considered sentinel nodes. On the basis of this criterion, 2 sentinel nodes were detected in 4 patients and one in the 44 remaining patients. The majority of the sentinel nodes turned out to be interfissural (61.53%), followed by those of hilar location (34.61%) and mediastinal (3.84%). Only in 2 patients with tumours in the upper left lobe were the sentinel nodes in subaortic and paraaortic locations. The presence of metastasis was shown in 16 out of 52 sentinel nodes (30.76%), all of which were in interfissural or hilar locations. The rate of false negatives reached 11.76%. The procedure precision was 95.83% and the negative predictive value of 93.94% with a global survival rate of 56.2% after 5 years. There was no evidence of complications in the series and the authors concluded that the intraoperative technique is feasible and safe.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The first thing that it is necessary to emphasise in this study is that, in spite of not having pre- nor intraoperative images, a systematic sweep was carried out of the possible stations of drainage in the thoracic cavity with the gamma probe, which would have reduced the possibility of having non-resected sentinel nodes in alternative regions. What we need to ask ourselves is whether this post-excision check can be replaced by the use of gammagraphy images, as used in other procedures to rule out instances of unexpected drainage. Another advantage of the preoperative image is that of identifying the sentinel nodes by applying the classic criteria based on the display of direct drainage from the tumour site. In the study published by Medicina Clínica, a criterion based on percentages of capture was applied to consider whether a lymph node is sentinel or not. Although this criterion often coincides with those based on the preoperative image, it can sometimes lead to an overestimation of the number of sentinel nodes and, on the other hand, leaving weak capture sentinel nodes unresected. It would also have been advantageous to have included in the study the precise location of the primary tumour, especially in the light of the results, in which more than 96% of sentinel nodes were found in the interfissural or hilar regions and only in slightly more than 4% was there a skip in drainage towards the mediastinal lymph stations, although without any metastatic effect. Finally, the authors used a radiocolloid of particles that were slightly larger than the nanocolloid used in many European countries for the standard of care of the sentinel node in other neoplasias.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The work presented by Uribe-Etxebarria Lugariza-Aresti et al.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> is promising and makes us think about an extension in its clinical validation which seeks to deliver an effective tool to surgeons and lung oncologists to provide proper staging of early NSCLC without evidence of lymph node spread. As has already been emphasised by Guidoccio et al.,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> it is necessary to think of a protocol design that does not rule out a priori the gammagraphy image in cases of tumours located within reach. That would allow the incorporation of new technologies such as image with SPECT/TC in the preoperative<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> or with portable equipment in the intraoperative.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> The preoperative image would, in addition, rule out possible drainage to alternative regions and meanwhile lengthen the duration of the diagnostic window of visualisation of the sentinel node to several hours after the injection. The preoperative image could be used in patients with peripherally located NSCLC, where it is possible to inject the radiopharmaceutical product in the site of the tumour under guidance from TC. Also in cases of more centralised location and which can be treated by bronchoscopy or even by transbronchial means. The important thing is to stress that the sentinel node procedure is in essence based on the personalisation of the protocol, recognising a variability of individual drainage in accordance with the modern concept introduced by Morton et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> and with clear potential applications to complement staging and treatment in resectable lung cancer.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> Its definitive incorporation in clinical oncology will depend not only on the optimisation of the procedure protocols, in accordance with the individual presentation of the NSCLC, but also based on its long-term assessment in prospective clinical series which help to confirm necessary reliability.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Valdés Olmos RA, Vidal-Sicart S. Ganglio centinela en el cáncer pulmonar. Med Clin (Barc). 2017;148:260–261.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technical details of intraoperative lymphatic mapping for early stage melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.L. Morton" 1 => "D.R. Wen" 2 => "J.H. Wong" 3 => "J.S. Economou" 4 => "L.A. Cagle" 5 => "F.K. Storm" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Surg" "fecha" => "1992" "volumen" => "127" "paginaInicial" => "392" "paginaFinal" => "399" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1558490" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[in press]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radioguided surgery: novel applications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.A. Valdés Olmos" 1 => "F. Orsini" 2 => "F. Giammarile" 3 => "S. Vidal-Sicart" 4 => "G. Mariani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/978-3-319-26067-9_55-1" "LibroEditado" => array:2 [ "titulo" => "Nuclear oncology, from pathophysiology to clinical applications" "serieFecha" => "2016" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A critical reappraisal of sentinel lymph node biopsy for non-small cell lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Guidoccio" 1 => "F. Orsini" 2 => "G. Mariani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Transl Imaging" "fecha" => "2016" "volumen" => "4" "paginaInicial" => "385" "paginaFinal" => "394" "itemHostRev" => array:3 [ "pii" => "S0302283808008397" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contribution of SPECT/CT imaging to radioguided sentinel lymph node biopsy in breast cancer, melanoma, and other solid cancers: from open and see to see and open" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.A. Valdés Olmos" 1 => "D.D. Rietbergen" 2 => "S. Vidal-Sicart" 3 => "G. Manca" 4 => "F. Giammarile" 5 => "G. Mariani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Q J Nucl Med Mol Imaging" "fecha" => "2014" "volumen" => "58" "paginaInicial" => "127" "paginaFinal" => "139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24835289" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biopsia del ganglio centinela en cáncer del pulmón" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Uribe-Etxebarria Lugariza-Aresti" 1 => "R. Barceló Galíndez" 2 => "J. Pac Ferrer" 3 => "J. Méndez Martín" 4 => "J. Genollá Subirats" 5 => "J. Casanova Viudez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin" "fecha" => "2017" "volumen" => "148" "paginaInicial" => "257" "paginaFinal" => "259" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphoscintigraphy in early-stage non-small cell lung cancer with technetetium-99<span class="elsevierStyleHsp" style=""></span>m nanocolloids and hybrid SPECT/CT: a pilot project" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.T. Abele" 1 => "K. Allred" 2 => "T. Clare" 3 => "E.L.R. Bédard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12149-014-0821-1" "Revista" => array:6 [ "tituloSerie" => "Ann Nucl Med" "fecha" => "2014" "volumen" => "28" "paginaInicial" => "477" "paginaFinal" => "483" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24557659" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Synergism of SPECT/CT and portable gamma cameras for intraoperative sentinel lymph node biopsy in melanoma, breast cancer, and other malignancies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Vidal-Sicart" 1 => "R.A. Valdés Olmos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Transl Imaging" "fecha" => "2016" "volumen" => "4" "paginaInicial" => "313" "paginaFinal" => "327" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current innovations in sentinel lymph node mapping for the staging and treatment of resectable lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.J. Hachey" 1 => "Y.L. Colson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Semin Thoracic Surg" "fecha" => "2014" "volumen" => "26" "paginaInicial" => "201" "paginaFinal" => "209" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014800000006/v1_201704120030/S2387020617301857/v1_201704120030/en/main.assets" "Apartado" => array:4 [ "identificador" => "43314" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014800000006/v1_201704120030/S2387020617301857/v1_201704120030/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617301857?idApp=UINPBA00004N" ]
