J.Jpn. Surg. Soc.. 110(2): 82-85, 2009

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Feature topic

CURRENT STATUS AND NEW APPLICATIONS OF SENTINEL LYMPH NODE MAPPING IN NON-SMALL CELL LUNG CANCER

Sentinel lymph node (SLN) mapping has become a common procedure in the treatment of breast cancer and malignant melanoma. Its primary benefit is that it enables surgeons to avoid nontherapeutic lymph node dissection and the complications that may follow. All present evidence demonstrates the existence of SLNs in non-small cell lung cancer (NSCLC). However, SLN mapping is not widely used in the treatment of NSCLC for several reasons: first, special precautions are required to minimize exposure to radioisotopes; second, it is difficult to detect a dye within anthoracotic thoracic lymph nodes; and third, major complications comparable to the arm edema seen in breast cancer or the lymphedema and nerve injury seen in melanoma are not seen with mediastinal lymph node dissection. However, if the SLN mapping procedure were simplified, it could be used to avoid nontherapeutic mediastinal lymph node dissection in NSCLC. Recently, new applications of SLN mapping have been reported, such as the detection of lymph node micrometastases and segmentectomy for NSCLC. We expect SLN mapping to become a common clinical practice in the treatment of NSCLC in the near future.

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