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Results for “Lymph Node Excision”

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PubMed2003

[Sentinel lymph node excision (SLNE) and positron emission tomography in the staging of stage I-II melanoma patients].

BACKGROUND AND OBJECTIVE: Sentinel lymph node excision (SLNE) and positron emission tomography (PET) were evaluated in the staging of 51 Stage I and II melanoma patients (staged according to the guidelines of the German Dermatological Society). PATIENTS/METHODS AND RESULTS: Tumor thickness ranged from 1.0 mm to 6.0 mm (median: 1.5 mm; mean: 2.07 mm). At least one sentinel lymph node (SLN) was excised in all patients; 80 SLN were excised from 69 lymphatic drainage areas. Positive SLN were detected in 6 patients (11.8%). Additional positive lymph nodes were not detected in any of these patients in the following complete lymph node dissection of the affected lymph node basin. Preoperative PET was performed in 40 patients and did not detect any of the micrometastases that were subsequently found by SLNE. During the follow up of 7-40 months (mean 21.9 months) 3 patients experienced tumor progression; 2 of 3 had a positive SLN. CONCLUSIONS: According to the current literature SLNE is recommended in primary tumors greater than 1 mm thickness. PET cannot be expected to give additional information in the staging of stage I-II patients.

Adult↗
PubMed1990

[The extent of radical axillary lymph node excision].

A study on histological findings in 1047 patients who underwent total axillary lymph node dissection (topographical levels I-III), was conducted. A mean of 20.3 lymph nodes (LN) was assessed; LN metastases were detected in 492 cases. Retrospective analysis showed that, by mere dissection of LNs level I, 10 of the 492 nodal positive cases (2.0%) would have been classified false negative. Additionally, according to the number of positive LNs detected in stage I, 85 of the 492 patients (17%) would have been assigned to a group with a better prognosis (prognostic groups 1-3, 4-9, greater than or equal to 10 pos. LNs). By mere dissection of LNs levels I and II, only 1 of 492 (0.2%) patients would have been categorized false negative and only 24 patients (5%) would have been included in a group with a better prognosis, on the basis of the number of positive LNs dissected. Thus dissection of LNs stages I and II provides sufficient prognostic information. Since, however, in 145 nodal positive cases (14% of the entire collective e.g. 29.5% of all patients with positive lymph nodes), metastases were detected in level III, these LNs should be removed as well, in order to prevent axillary recurrences. One could only dispense with dissection of level III, if LN metastases levels I and II could be excluded during the operation.

Axilla↗
PubMed1998

[The value of palpation as basis for decision on lymph node excision].

The purpose of the study was to evaluate palpation of the regional lymph nodes in control examinations of patients with malignant disease. A retrospective review of the medical records of 188 cases in which the patients had had an extirpation of the regional lymph nodes was performed. We have compared the preoperative findings through palpation with the histological diagnosis. The patients were grouped according to the region in which the lymph node removal had been done. The specificity of palpation when the histological diagnosis was malignant was (with 95% confidence limits), in the axilla 0.65 (0.54-0.75), in the inguinal region 0.86 (0.75-0.94) on the neck 0.83 (0.52-0.98) and in the suprahyoid region 0.58 (0.28-0.85). In conclusion, palpation of regional lymph nodes is not a sufficient control examination in the estimation of the course of malignant disease. Supplementary examination methods are recommended.

Axilla↗
PubMed1990

[Peripheral nerve injuries as a rare complication of cervical lymph node excision for diagnostic purposes].

During the last 3 years 263 patients were admitted who underwent diagnostic lymph node biopsy. Complications were observed only in 4 cases. In these cases, following cervical lymph node excision from the supraclavicular region, sectioning the spinal accessory nerve and branches of brachial plexus resulted in the "shoulder syndrome" which is characterized by a weakened, deformed, and often painful shoulder. Attention is called to the possibility of nerve injury during diagnostic excision of cervical lymph nodes. Most often the spinal accessory nerve and branches of brachial plexus are transected with subsequent deformity and decreased range of motion of the shoulder, which could influence deeply the quality of patient's life.

Aged↗
PubMed1996

[Principles and value of lymph node excision in colorectal carcinoma].

Systematic lymphadenectomy for colorectal cancer aims to remove potentially metastatic lymph nodes from the tumor's drainage basin. This requires knowledge of normal lymphatic anatomy and metastatic routes. Systematic lymphadenectomy performed as a standard or as an extended resection is a prerequisite for pathologic tumor staging. An intensive search by the pathologist for lymph node metastases is critical for precise staging. Recommendations as to the extent of lymphadenectomy are derived from potential improvement of prognosis and procedure-related complications.

Colorectal Neoplasms↗
PubMed1988

[Scintigraphic studies of the lymph nodes in patients with melanoma following lymph node excision].

We report on 20 patients suffering from malignant melanoma, who had undergone regional lymph node dissection. In order to make certain that all the lymph nodes had been completely removed, we performed lymphoscintigraphy 3 to 6 weeks after block dissection with the help of a radiopharmacon intercostally or interdigitally applied. We judged the removal to be complete, if neither intercostal nor interdigital application led to any evidence of regional lymph nodes. On the basis of our experiences so far, we consider postoperative lymphoscintigraphy a suitable non-invasive method to check the completeness of block dissection.

Adult↗
PubMed1998

[Diagnostic relevance of lymph node size after 2-field lymph node excision in esophagus carcinomas].

In 22 patients with thoracoabdominal esophagectomy and 2-field lymphadenectomy the lymph nodes (LN) were dissected according to a standardized protocol and classified in five groups regarding their size. 407 of 675 dissected LN (60.3%) were < 5 mm. 89.4% of the metastatic LN were < 10 mm although LN > 10 mm showed significantly more metastases than LN < 10 mm. Since diagnostic imaging defines metastatic LN by a diameter > 10 mm these results demonstrate the inaccuracy to evaluate preoperatively the cN-status. These results also support the need of a systematic lymphadenectomy in patients with esophageal cancer.

Diagnostic Imaging↗
PubMed1990

[Decision-making for lymph node excision in surgery of thyroid cancer. Extemporaneous examination of the external supraclavicular lymph nodes].

UNLABELLED: Modified neck dissection (MND) is not recommended for surgery of thyroid carcinoma (TC) in the absence of grossly involved nodes, except for medullary thyroid carcinoma, and clinical node recurrence in uncommon at follow-up (3% for us). But several authors report metastatic cancer in non-palpable nodes up to 70% on MND specimens. The fear of overlooking occult metastatic nodes prompted us to sample even normal appearing nodes and to rely on frozen sections (FS) to make a decision whether or not a MND should be done. PATIENTS AND METHODS: 130 among 300 consecutive patients operated for TC were submitted to supraclavicular node sampling with FS. All pathological varieties were covered. In 170 cases, sampling was not done purposely (lack of intraoperative diagnosis of carcinoma: 75) or for other reasons (absence of obvious nodes: 77; unavailable pathologist: 14; miscellaneous: 4). All specimens were reviewed by paraffin sections (PS). RESULTS: Among the 130 patients; 25 had gross metastatic node involvement, confirmed by FS+ and PS+; 1 had grossly equivocal nodes with FS- and PS+; 104 had grossly normal nodes. In 101 (97%) this was confirmed by FS- and PS-. In 3 (3%) FS was +, leading to MND, and PS confirmed metastatic involvement in 2. All 32 specimens of routine node sampling done in 1988 have been reviewed by serial cross sections, one each millimeter (331 sections). One only disclosed one occult metastatic invasion. CONCLUSION: No more than 3% of the grossly normal supraclavicular nodes are metastatic at the time of surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma↗
PubMed2001

[Lymph node excision with laparotomy and chemo-radiation therapy for a hepatocellular carcinoma patient with multiple lymph node metastases].

We reported a case of hepatocellular carcinoma (HCC) with multiple lymph node metastases. The patient was a 67-year-old male with C type liver cirrhosis. He underwent microwave coagulation therapy (MCT) for HCC (5 cm and 1.5 cm) 1.5 years before admission. Abdominal CT scan revealed a well-enhanced tumor (2 cm) in caudate lobe of the liver and excessive lymph node metastases, locating in the inferior phrenic, periportal and para-aortic area. The preoperative serum AFP and AFP-L3 levels were 41.9 ng/ml and 93.1%, respectively. At laparotomy, systematic dissection of the enlarged lymph nodes and MCT of the hepatic tumor was performed. After operation, residual inferior phrenic lymph node was treated with irradiation therapy (total 50.4 Gy). The lymph node showed complete response (CR) for about a year and the AFP-L3 level returned to the normal range. After 9 months, a supra-clavicular lymph node was detected on abdominal CT scan. Irradiation therapy (total 45 Gy) in combination with CDDP (100 mg) and 5-FU (4,000 mg) was applied. The lymph node had been assessed as partial response for 6 months. The patient lived quite well after these therapies, but died of hepatic failure 32 months after the initial operation. In conclusion, we recommend this therapeutic strategy using operative excision and chemo-radiation therapy for HCC with multiple lymph node metastases.

Aged↗