Early experience in intermediate-risk penile cancer with sentinel node identification using the gamma probe
Identifieur interne : 009F62 ( Main/Exploration ); précédent : 009F61; suivant : 009F63Early experience in intermediate-risk penile cancer with sentinel node identification using the gamma probe
Auteurs : Bulent Akduman [Canada] ; Neil E. Fleshner [Canada] ; Lisa Ehrlich [Canada] ; Laurence Klotz [Canada]Source :
- Urology [ 0090-4295 ] ; 2001.
Abstract
Objectives. To report the initial experience with sentinel node identification using the gamma probe in patients with intermediate-risk penile cancer (T2NXM0, or T1 with intermediate or high-grade disease) and impalpable groin nodes. Methods. Technetium-99m-labeled sulfur colloid was injected at the site of primary penile carcinoma 1 hour before surgery. The sentinel lymph nodes were located using the gamma probe and excised through a 3-cm inguinal incision. A full groin dissection was performed only in cases in which frozen section of the node demonstrated metastasis. Results. Nine sentinel nodes were identified by the gamma probe and excised in 5 men. In 3 patients, the sentinel nodes were negative bilaterally. In 2 patients, the sentinel node, although grossly normal, showed a single focus of metastasis by frozen section analysis. In both of these patients, a full groin dissection was carried out and revealed no other nodal metastases. All 5 remained free of recurrence (median follow-up 18 months, range 16 to 23). Conclusions. In patients with microscopic involvement of a single lymph node only (confirmed by full groin dissection), gamma probe identification was 100% accurate. None of the patients with negative sentinel nodes had a recurrence. Biopsy of the sentinel nodes using the gamma probe can predict the presence or absence of inguinal node metastasis in patients with intermediate-risk penile cancer, sparing many patients the long-term morbidity of a full groin dissection. These initial results suggest further study is warranted.
Url:
DOI: 10.1016/S0090-4295(01)01087-1
Affiliations:
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Fleshner</name></author><author><name sortKey="Ehrlich, Lisa" sort="Ehrlich, Lisa" uniqKey="Ehrlich L" first="Lisa" last="Ehrlich">Lisa Ehrlich</name></author><author><name sortKey="Klotz, Laurence" sort="Klotz, Laurence" uniqKey="Klotz L" first="Laurence" last="Klotz">Laurence Klotz</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:6E76D78ECBF9A34619468F6F04A150FDE176F4C8</idno><date when="2001" year="2001">2001</date><idno type="doi">10.1016/S0090-4295(01)01087-1</idno><idno type="url">https://api.istex.fr/document/6E76D78ECBF9A34619468F6F04A150FDE176F4C8/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">003377</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">003377</idno><idno type="wicri:Area/Istex/Curation">003377</idno><idno type="wicri:Area/Istex/Checkpoint">002C67</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">002C67</idno><idno type="wicri:doubleKey">0090-4295:2001:Akduman B:early:experience:in</idno><idno type="wicri:Area/Main/Merge">00A416</idno><idno type="wicri:Area/Main/Curation">009F62</idno><idno type="wicri:Area/Main/Exploration">009F62</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Early experience in intermediate-risk penile cancer with sentinel node identification using the gamma probe</title><author><name sortKey="Akduman, Bulent" sort="Akduman, Bulent" uniqKey="Akduman B" first="Bulent" last="Akduman">Bulent Akduman</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Urology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Fleshner, Neil E" sort="Fleshner, Neil E" uniqKey="Fleshner N" first="Neil E" last="Fleshner">Neil E. Fleshner</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Radiology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Ehrlich, Lisa" sort="Ehrlich, Lisa" uniqKey="Ehrlich L" first="Lisa" last="Ehrlich">Lisa Ehrlich</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Urology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Klotz, Laurence" sort="Klotz, Laurence" uniqKey="Klotz L" first="Laurence" last="Klotz">Laurence Klotz</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Urology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Urology</title><title level="j" type="abbrev">URL</title><idno type="ISSN">0090-4295</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001">2001</date><biblScope unit="volume">58</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="65">65</biblScope><biblScope unit="page" to="68">68</biblScope></imprint><idno type="ISSN">0090-4295</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0090-4295</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objectives. To report the initial experience with sentinel node identification using the gamma probe in patients with intermediate-risk penile cancer (T2NXM0, or T1 with intermediate or high-grade disease) and impalpable groin nodes. Methods. Technetium-99m-labeled sulfur colloid was injected at the site of primary penile carcinoma 1 hour before surgery. The sentinel lymph nodes were located using the gamma probe and excised through a 3-cm inguinal incision. A full groin dissection was performed only in cases in which frozen section of the node demonstrated metastasis. Results. Nine sentinel nodes were identified by the gamma probe and excised in 5 men. In 3 patients, the sentinel nodes were negative bilaterally. In 2 patients, the sentinel node, although grossly normal, showed a single focus of metastasis by frozen section analysis. In both of these patients, a full groin dissection was carried out and revealed no other nodal metastases. All 5 remained free of recurrence (median follow-up 18 months, range 16 to 23). Conclusions. In patients with microscopic involvement of a single lymph node only (confirmed by full groin dissection), gamma probe identification was 100% accurate. None of the patients with negative sentinel nodes had a recurrence. Biopsy of the sentinel nodes using the gamma probe can predict the presence or absence of inguinal node metastasis in patients with intermediate-risk penile cancer, sparing many patients the long-term morbidity of a full groin dissection. These initial results suggest further study is warranted.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Akduman, Bulent" sort="Akduman, Bulent" uniqKey="Akduman B" first="Bulent" last="Akduman">Bulent Akduman</name></region><name sortKey="Ehrlich, Lisa" sort="Ehrlich, Lisa" uniqKey="Ehrlich L" first="Lisa" last="Ehrlich">Lisa Ehrlich</name><name sortKey="Fleshner, Neil E" sort="Fleshner, Neil E" uniqKey="Fleshner N" first="Neil E" last="Fleshner">Neil E. Fleshner</name><name sortKey="Klotz, Laurence" sort="Klotz, Laurence" uniqKey="Klotz L" first="Laurence" last="Klotz">Laurence Klotz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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