Sentinel lymph node in carcinoma of the thoracic esophagus

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Background : We assessed the detection of sentinel lymph nodes in patients with squamous cell carcinoma of the thoracic esophagus using technetium-99m colloidal rhenium sulfide.Methods : We observed 10 patients with thoracic esophageal carcinomas who underwent radical esophagectomy. The day before surgery, technetium-99m colloidal rhenium sulfide was injected into submucosa at four sites around the primary tumor. Lymphoscintigraphy was performed. Esophagectomy and radical lymph node dissection were performed 23 hours after the technetiunr99m injection. After surgery, the radioactivity of the resected lymph nodes was evaluated by the gamma probe.Results : Lymphoscintigraphy detected sentinel lymph nodes in 40% of the patients (4 of 10 patinets). In 9 of 10 patients, sentinel lymph nodes were detected by the gamma plobe after surgery. The number of sentinel lymph nodes was one to nine, and the number of lymph node stations existing sentinel lymph nodes was one to seven. In 3 patients with lymph node metastasis, positive nodes did not show the radioactivity. A comparison of the pattern of sentinel lymph nodes and clinicopathologic factors showed no siginificant association.Conclusions : We could not show that the lymphatic mapping with technetium-99m colloidal rhenium sulfide was available. The improvement and effort of lymphatic mapping technique are necessary.