ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Sentinel lymph node mapping in early stage non-small cell lung carcinoma
Cumhur Murat Tulay1, Muammer Cumhur Sivrikoz1, İlknur Ak2, Öznur Dilek Çiftçi2, Emine Özlem Akçay2, Emine Dündar3
1Department of Thoracic Surgery, Faculty of Medicine of Eskişehir Osmangazi University, Eskişehir, Turkey
2Department of Nuclear Medicine, Faculty of Medicine of Eskişehir Osmangazi University, Eskişehir, Turkey
3Department of Pathology, Faculty of Medicine of Eskişehir Osmangazi University, Eskişehir, Turkey
DOI : 10.5606/tgkdc.dergisi.2013.6373
Background: This study aims to assess the accuracy and feasibility of intraoperative sentinel lymph node (SLN) mapping in patients with clinical early stage (stage I-II) non-small cell lung carcinoma (NSCLC).

Methods: A total of 22 patients with pathologically proven clinically early stage NSCLC (2 females, 20 males; mean age 57.62 years; range 45 to 76 years) were included. During thoracotomy, tumor and nodal stations were surveyed with a hand-held gamma counter. Serial-section histological examination and immunohistochemistry were performed to confirm the presence of metastatic disease.

Results: According to preoperative results of fluorine-18- deoxyglucose (FDG) positron emission tomography (PET)/ computed tomography (CT) scan and mediastinoscopy, all of the 22 patients were clinical stage 1A (n=7), stage 1B (n=7), stage 2A (n=7) and stage 2B (n=1). A total of 422 lymph nodes were harvested in 22 patients undergoing thoracotomy and histological examination was performed (mean 19.2±1.8, range 6 to 37 lymph nodes). Metastatic involvement was detected in three of 22 SLNs (13.63%) in 22 patients. The identification rate of SLN was 81.81% and accuracy and sensitivity rate were 100%, while false negativity ratio was 0%.

Conclusion: Intraoperative SLN mapping can be performed in patients with NSCLC with a high accuracy and sensitivity rate. The knowledge of tumor lymphatic drainage by intraoperative SLN mapping in NSCLC may help the surgeon to perform a better lymphadenectomy and encourage the use of more sensitive pathological and molecular techniques to discover occult or micrometastatic disease.

Keywords : Early stage; mediastinoscopy; mediastinum; nonsmall cell lung cancer; sentinel lymph node
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