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DOI: 10.1055/s-2003-41159
Das Sentinel-Node-Konzept beim Kolonkarzinom
The Sentinel Node Concept in Colon CancerPublication History
Publication Date:
12 August 2003 (online)
![](https://www.thieme-connect.de/media/viszeralchirurgie/200304/lookinside/thumbnails/10.1055-s-2003-41159-1.jpg)
Zusammenfassung
Die Lymphadenektomie (LAE) wird beim Kolonkarzinom aus diagnostischen Erwägungen heraus, möglicherweise auch zur Prognoseverbesserung durchgeführt. Es wäre sinnvoll, die feingewebliche Untersuchung auf wenige, repräsentative Lymphknoten zu beschränken und eine LAE befundadaptiert durchzuführen. Dies sind die wesentlichen Ziele der Sentinel Node (SLN) Biopsie. Trotz erheblicher Unsicherheiten bez. der idealen Untersuchungstechnik zeigt die noch limitierte Erfahrung im Schrifttum an, dass die grundsätzliche Richtigkeit des SLN-Konzeptes auch beim Kolonkarzinom besteht. Der SLN scheint in hohem Maße identifizierbar, kann den Nodalstatus des Lymphknoten-Kompartimentes verlässlich vorhersagen, mag zum „upstaging” von-Dukes B-Karzinomen beitragen und könnte in Zukunft für die Entscheidung zur erweiterten LAE von Belang sein. Ob ein Verzicht auf eine LAE bei nodal-negativen Patienten sinnvoll sein könnte, ist zurzeit unklar.
Abstract
In colon cancer patients, lymphadenectomy is carried out for diagnostic reasons, possibly also to improve outcome. The chief goals of sentinel node biopsy are to reduce histological investigation to one or few representative lymph nodes and to confine systematic lymphadenectomy to patients with lymphatic metastasis. Despite considerable uncertainty concerning the ideal technique, recently published data indicate that SLN biopsy is feasible also in colon cancer. The SLN can be identified with a high success rate, may predict the status of locoreginonal lymphnodes accurately, is likely to upstage some Dukes' B cancer patients because of micrometastatic disease and could be valid to plan extended lymphadenectomy in future. To date, it is unclear whether a tailored lymphadenectomy on the basis of SLN-status could be beneficial to reduce perioperative morbidity.
Schlüsselwörter
Kolonkarzinom - Lymphadenektomie - Sentinel-Node-Biopsie
Key words
Colon cancer - lymphadenectomy - sentinel node biopsy
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