Radioguided sentinel lymph node dissection in patients with localised prostate carcinoma: influence of the dose of radiolabelled colloid to avoid failure of the procedure
Radioguided sentinel lymph node dissection in patients with localised prostate carcinoma: influence of the dose of radiolabelled colloid to avoid failure of the procedure
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DOI：
10.1007/s00259-007-0516-0
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发表时间：
2008-01-01
影响因子：
9.1
通讯作者：
Bastide, Cyrille
中科院分区：
文献类型：
--
作者：
Brenot-Rossi, Isabelle;Rossi, Dominique;Bastide, Cyrille
本研究的目的是确定示踪剂注射剂量在前列腺癌患者盆腔前哨淋巴结（SLN）未检出中的作用。方法收集100例患者资料，年龄43 ~ 77岁，平均63岁。前72例患者（1组）接受30 MBq纳米胶体-99 mTc 2 × 0.3 ml治疗，其余28例患者（2组）接受100 MBq 2 × 0.3 ml治疗。手术包括检测和淋巴结清扫，确定为前哨淋巴结，随后进行扩大淋巴结切除术。结果sln位于髂内组的占54.2%，位于闭孔窝的占30.7%，位于髂外组的占10.9%，位于普通髂组的占4.2%。12%的患者有淋巴结受累。组1和组2的失败率分别为30.6%（22/72）和7.1%（2/28）。低剂量的mbq纳米胶体会增加SLN手术失败的风险（p < 0.017）。将前30例患者排除在研究（团队学习阶段）后，也发现有统计学相关性（p < 0.034）。其他参数均无统计学意义（年龄，p < 0.9； Gleason评分，p < 0.3； pT分级，p < 0.7）。前列腺癌在前列腺内的更高级别或更大范围的扩散不是SLN手术失败的原因。结论为避免SLN手术失败，应在前列腺内注射至少200mbq。
Introduction The purpose of this study was to determine the role of the injected dose of tracer in the non-detection of pelvic sentinel lymph nodes (SLN) in patients with prostate carcinoma.Methods Data were evaluated from 100 patients (age range 43-77, mean 63 years). The first 72 patients (group 1) received 2 x 0.3 ml of 30 MBq-nanocolloid-99 mTc and the remaining 28 patients (group 2) received 2 x 0.3 ml of 100 MBq. Surgery consisted of the detection and dissection of lymph nodes identified as sentinel nodes, followed by an extended lymphadenectomy.Results SLNs were located in the interiliac group in 54.2% of patients, in the obturator fossa in 30.7%, in the external iliac group in 10.9% and in the common iliac group in 4.2% of cases. Lymph node involvement was observed in 12% of patients. But there was a 30.6% (22/72) failure rate of the SLN procedure in group 1 and 7.1% (2/28) in group 2. An increased risk of unsuccessful SLN procedure was statistically associated with the low dose of MBq-nanocolloids (p < 0.017). Statistical correlation is also found after the exclusion of the first 30 patients from the study (learning phase of the team) (p < 0.034). None of the other parameters showed a statistical association (age, p < 0.9; Gleason score, p < 0.3; grade pT, p < 0.7). A higher grade or a greater extension of cancer inside the prostate are not responsible for the failure of the SLN procedure.Conclusion It seems necessary to inject at least 200 MBq inside the prostate to avoid a failed SLN procedure.