Sentinel node biopsy and lymphatic mapping in penile and prostate cancer

Background Nodal metastases are linked to poor outcome in men with penile or prostate cancer. Early detection and resection are important for staging and for the prognosis. However, lymphadenectomy is associated with morbidity and may miss metastases when performed solely on the basis of anatomical...

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Bibliographic Details
Published in:Urologe. Ausgabe A 2017, Vol.56 (1), p.13-17
Main Authors: van der Poel, H. G., Meershoek, P., Grivas, N., KleinJan, G., van Leeuwen, F. W. B., Horenblas, S.
Format: Article
Language:English
Subjects:
Early Detection of Cancer - methods
Humans
Image-Guided Biopsy - methods
Leitthema
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Penile Neoplasms - diagnostic imaging
Penile Neoplasms - pathology
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - pathology
Reproducibility of Results
Sensitivity and Specificity
Sentinel Lymph Node - diagnostic imaging
Sentinel Lymph Node - pathology
Sentinel Lymph Node Biopsy - methods
Single Photon Emission Computed Tomography Computed Tomography - methods
Urology
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Summary:Background Nodal metastases are linked to poor outcome in men with penile or prostate cancer. Early detection and resection are important for staging and for the prognosis. However, lymphadenectomy is associated with morbidity and may miss metastases when performed solely on the basis of anatomical templates. Methods In this article we describe the technique and benefits of sentinel node biopsy (SNB) and provide a review of the literature. Results Dynamic sentinel node techniques using both radioactive and optical (hybrid) tracers have been proven effective in penile cancer. For prostate cancer, SNB added to extended nodal dissection may further tailor dissection to the highly variable lymphatic drainage patterns in the pelvis. The sensitivity of SNB was found to be superior to conventional imaging methods; however, false-negative SNB procedures can occur and a complementary extensive lymphadenectomy is required to remove additional positive nodes that were not detected in the SNB template. Conclusion SNB is a standard method for early detection of nodal metastases in penile cancer and provides superior diagnostic accuracy to conventional imaging modalities in prostate cancer.
ISSN:0340-2592
1433-0563
DOI:10.1007/s00120-016-0270-7