Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

Sentinel lymph node mapping in post chemotherapy nonseminoma testicular cancer patients undergoing retroperitoneal lymph node dissection: A series of nine cases

Document Type : Original Article

Authors
Leili Zarifmahmoudi 1
Hamidreza Ghorbani 2
Ramin Sadeghi 1
Kayvan Sadri 1
Salman Soltani 2
Atena Aghaee 1
1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Kidney transplantation complications research center, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/aojnmb.2021.55218.1380
Abstract
Objective(s): Testicular germ cell cancers are the most common solid malignancy among young men at the age ranging between 14 and 35 years. In this study, we evaluated the feasibility of sentinel lymph node mapping using intraoperative injection of radiotracer in nonseminomatous testicular cancer patients with history of orchiectomy who were candidate for retroperitoneal lymph node dissection (RPLND) in post-chemotherapy setting.
Methods: Nine consecutive cases were included in the study. Technetium-99m-labelled phytate was injected in two divided doses in the stump of the spermatic cord, through transabdominal approach. A hand-held gamma probe was used for radio-guided retroperitoneal sentinel lymph node detection intraoperatively and confirming the location of the sentinel lymph nodes.
Results: Detection rate and the false negative rate were estimated as the main indices. The detection rate was 6/9 (66%) and the false negative rate was 0/2 (0%). Location of the dissected sentinel lymph nodes were interaortocaval (2 patients), internal iliac (1 patient), external iliac (1 patient), common iliac (2 patients), and paraaortic (1 patient).
Conclusion: Sentinel lymph node mapping technique seems to be feasible and promising in post chemotherapy non-seminoma testis cancer patients who are candidate for RPLND; however, further larger studies are needed to increase and standardize the detection rate. 
Keywords
Nonseminoma
Retroperitoneal lymph node dissection
Chemotherapy
Sentinel lymph node
Nuclear medicine
Cancer
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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 10, Issue 1
January 2022
Pages 36-42