Sentinel node procedure in colorectal carcinoma

Abstract

This thesis describes the sentinel node procedure in colorectal carcinoma and the possible value of in-depth analysis of this sentinel node. The sentinel node procedure can be successfully performed in colon carcinoma. However, it is not reliable in rectal carcinoma treated with total mesorectal excision after preoperative short-course radiotherapy, which is the current protocol in The Netherlands and other countries. RT-PCR with CEA, on mRNA extracted from paraffin-embedded sentinel nodes, upstages 17 __ 25 % of patients and accurately predicts lymph node status. A 5-year follow-up of the sentinel node procedure in colon carcinoma -with, but even without, in-depth pathological examination- shows excellent results of the patients in de node-negative group with 100 % cancer-specific 5-year survival and 96 % disease-free 5-year survival. These node-negative patients do not need further treatment. The sentinel node procedure can be easily introduced in clinical practice in every clinic, and should be considered for all patients with colon carcinoma.