“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”
Abstract Background In current best practise, curatively intended treatment for oesophageal cancer usually consists of neoadjuvant chemo-radiotherapy (nCRT) or perioperative chemotherapy, and oesophagectomy. Sentinel Lymph Node Biopsy (SLNB) has the potential to identify patients without lymph node...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-12-01
|
Series: | Cancer Imaging |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s40644-018-0185-1 |
id |
doaj-475eea7cc3564c7685670831e352f8ab |
---|---|
record_format |
Article |
spelling |
doaj-475eea7cc3564c7685670831e352f8ab2021-03-02T07:58:16ZengBMCCancer Imaging1470-73302018-12-011811810.1186/s40644-018-0185-1“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”Stefan Gabrielson0Jon A. Tsai1Fuat Celebioglu2Magnus Nilsson3Ioannis Rouvelas4Mats Lindblad5Annie Bjäreback6Artur Tomson7Rimma Axelsson8Department of Nuclear Medicine, Karolinska University HospitalDepartment of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska InstitutetDepartment of Clinical Science and Education, Södersjukhuset, Division of SurgeryDepartment of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska InstitutetDepartment of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska InstitutetDepartment of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska InstitutetDepartment of Nuclear Medicine, Karolinska University HospitalDepartment of Nuclear Medicine, Karolinska University HospitalDepartment of Nuclear Medicine, Karolinska University HospitalAbstract Background In current best practise, curatively intended treatment for oesophageal cancer usually consists of neoadjuvant chemo-radiotherapy (nCRT) or perioperative chemotherapy, and oesophagectomy. Sentinel Lymph Node Biopsy (SLNB) has the potential to identify patients without lymph node metastases and thus improve the staging accuracy and influence treatment. The impact of neoadjuvant treatment on the lymphatic drainage of oesophageal cancers and subsequently the SLNB procedure in this tumour type has previously not been well studied. Purpose To evaluate changes in lymphatic drainage patterns of the tumour in patients with cancer of the oesophagus or gastro-oesophageal junction (GOJ) using Sentinel Lymph Node (SLN) hybrid SPECT/CT lymphoscintigraphy before and after nCRT. Methods Patients with clinical stage T2-T3, any N-stage, M0 cancer of the oesophagus or GOJ underwent endoscopically guided peri−/intratumoral injection of radio-colloid followed by hybrid SPECT/CT lymphoscintigraphy prior to, and once again following, nCRT. SPECT/CT images were evaluated to number and location of SLNs and compared between the two examinations. Results Ten patients were included in this pilot trial. SPECT/CT lymphoscintigraphy was performed in twenty procedures. The same Sentinel Lymph Node station before and after nCRT was observed in one single patient. In two patients, no SLN was detected before nCRT. In three patients no SLN was detected following nCRT. In four patients, the SLN stations were not the same station at baseline compared to follow-up examination. Conclusions The reproducibility SLN detection in patients with cancer of the oesophagus/GOJ following nCRT was very poor. nCRT appears to alter lymphatic drainage patterns and thus may affect detection of SLNs and potentially also the accuracy of an SLNB in these patients. On the basis of these initial results, we abort further patient recruitment in our institution. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR). Identifier ACTRN12618001433291. Date registered: 27/08/2018. Retrospectively registered.http://link.springer.com/article/10.1186/s40644-018-0185-1Oesophageal cancerNeoadjuvant therapyLymphatic structuresSentinel lymph node conceptSPECT/CT |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefan Gabrielson Jon A. Tsai Fuat Celebioglu Magnus Nilsson Ioannis Rouvelas Mats Lindblad Annie Bjäreback Artur Tomson Rimma Axelsson |
spellingShingle |
Stefan Gabrielson Jon A. Tsai Fuat Celebioglu Magnus Nilsson Ioannis Rouvelas Mats Lindblad Annie Bjäreback Artur Tomson Rimma Axelsson “Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” Cancer Imaging Oesophageal cancer Neoadjuvant therapy Lymphatic structures Sentinel lymph node concept SPECT/CT |
author_facet |
Stefan Gabrielson Jon A. Tsai Fuat Celebioglu Magnus Nilsson Ioannis Rouvelas Mats Lindblad Annie Bjäreback Artur Tomson Rimma Axelsson |
author_sort |
Stefan Gabrielson |
title |
“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” |
title_short |
“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” |
title_full |
“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” |
title_fullStr |
“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” |
title_full_unstemmed |
“Sentinel lymph node imaging with sequential SPECT/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” |
title_sort |
“sentinel lymph node imaging with sequential spect/ct lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study” |
publisher |
BMC |
series |
Cancer Imaging |
issn |
1470-7330 |
publishDate |
2018-12-01 |
description |
Abstract Background In current best practise, curatively intended treatment for oesophageal cancer usually consists of neoadjuvant chemo-radiotherapy (nCRT) or perioperative chemotherapy, and oesophagectomy. Sentinel Lymph Node Biopsy (SLNB) has the potential to identify patients without lymph node metastases and thus improve the staging accuracy and influence treatment. The impact of neoadjuvant treatment on the lymphatic drainage of oesophageal cancers and subsequently the SLNB procedure in this tumour type has previously not been well studied. Purpose To evaluate changes in lymphatic drainage patterns of the tumour in patients with cancer of the oesophagus or gastro-oesophageal junction (GOJ) using Sentinel Lymph Node (SLN) hybrid SPECT/CT lymphoscintigraphy before and after nCRT. Methods Patients with clinical stage T2-T3, any N-stage, M0 cancer of the oesophagus or GOJ underwent endoscopically guided peri−/intratumoral injection of radio-colloid followed by hybrid SPECT/CT lymphoscintigraphy prior to, and once again following, nCRT. SPECT/CT images were evaluated to number and location of SLNs and compared between the two examinations. Results Ten patients were included in this pilot trial. SPECT/CT lymphoscintigraphy was performed in twenty procedures. The same Sentinel Lymph Node station before and after nCRT was observed in one single patient. In two patients, no SLN was detected before nCRT. In three patients no SLN was detected following nCRT. In four patients, the SLN stations were not the same station at baseline compared to follow-up examination. Conclusions The reproducibility SLN detection in patients with cancer of the oesophagus/GOJ following nCRT was very poor. nCRT appears to alter lymphatic drainage patterns and thus may affect detection of SLNs and potentially also the accuracy of an SLNB in these patients. On the basis of these initial results, we abort further patient recruitment in our institution. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR). Identifier ACTRN12618001433291. Date registered: 27/08/2018. Retrospectively registered. |
topic |
Oesophageal cancer Neoadjuvant therapy Lymphatic structures Sentinel lymph node concept SPECT/CT |
url |
http://link.springer.com/article/10.1186/s40644-018-0185-1 |
work_keys_str_mv |
AT stefangabrielson sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT jonatsai sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT fuatcelebioglu sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT magnusnilsson sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT ioannisrouvelas sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT matslindblad sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT anniebjareback sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT arturtomson sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy AT rimmaaxelsson sentinellymphnodeimagingwithsequentialspectctlymphoscintigraphybeforeandafterneoadjuvantchemoradiotherapyinpatientswithcanceroftheoesophagusorgastrooesophagealjunctionapilotstudy |
_version_ |
1724240825051774976 |