Sentinel Node Mapping Feasible For Lung Cancers

[MJ]

NEW YORK AUG 25, 2004 (Reuters Health) - Although technically challenging, lymphatic mapping and sentinel lymphadenectomy can be successfully performed in primary and metastatic pulmonary malignancies. Moreover, such testing provides important prognostic information, researchers report in the August issue of the Archives of Surgery.

Dr. Donald L. Morton and colleagues from St. John's Health Center in Santa Monica, California, reviewed the use of sentinel node mapping in 67 patients who underwent lung tumor resection at their institution. The group consisted of 28 patients with primary lung cancers and 39 with metastatic lung lesions.

Lymphatic mapping and sentinel node excision was successfully performed in all patients, the researchers report. The median number of nodes identified by dye alone was 2 and with dye plus radiocolloid, the figure was 4.

Sixty-nine percent of sentinel nodes were N1 and 31% were N2, the investigators note. In 3 of 24 cases, a lower lobe lesion drained to an upper mediastinal node.

Nodal metastases were observed in 11 patients with a primary lung tumor (39%) and in 8 patients with lung metastases (21%), the authors point out. Of the 11 primary tumor patients, only one did not have sentinel node involvement.

Among the 33 patients with metastatic melanoma, the authors found that sentinel node involvement predicted no survival at 2 years. In contrast, without such involvement, the 2-year survival rate was 48%.

Overall, the approach is feasible and accurate in such patients, the investigators conclude, and "when combined with modern techniques in pathology, it will prove to be a practical method of improving lymphatic staging in primary lung cancer."

[Elaine]

It's a shame they aren't spending money trying to cure lc and spending it on better ways to let us know when we are going to die--shessh.

elaine

[BeckyCW]

MJ, thanks for posting this. I worked for Dr. Morton's research institute (the John Wayne Cancer Institute at St. John's in Santa Monica) for a couple of years. He is a pioneer in cancer vaccines and other things, and leads a team of great researchers. Much of his early work involved malignant melanoma.

Back when I worked there, they were coordinating the national sentinal node study for breast cancer. That has resulted in doctors everywhere now being able to see, in breast cancer patients, which lymph nodes cancer has spread to and which it has not, thus saving healthy lymph nodes and taking out only ones that need to be removed. (Removing lymph nodes that still work is not good!) I'm sure it also was good for helping doctors and patients make decisions about other treatments to have or not to have. I hope this is one more step towards treating lung cancer better, too.

BeckyCW

[Elaine]

After reading your post and doing a search on "sentinel nodes", I guess I better understand this article! I still wish that with the paucity of funds going to LC research that more dollars were spent on early detection and CURE--and less on cost effectiveness--which, when it comes down to it, this does impact. I don't mean to put down your friend, since I see that there is a way in many cases, that this might be helpful.

elaine

[chloesmom]

Well, sentinel node dissection for breast cancer patients has been a positive thing. The most likely node for spread is identified and removed for pathology. It is much less damaging to remove 4 relevant nodes than 25-35 nodes all under your arm to test them all for malignancy.

Those people who have all those nodes removed have life long issues with the risk of lymphadema of that arm.

I had sentinel node surgery for my breast tumor and I am so glad we were able to do that rather than the traditional total lymph node removal and testing.

I think this is a good move for us--it will allow for much more accurate staging and hopefully less problems with draining of lymph fluid once the patient recovers.....anything less invasive and more definitive is a good thing. I hope this really turns out to be the standard of care for lung patients as well as breast patients.

Cindy