Umfang:
Online-Ressource (XII, 297 p. With DVD, digital)
ISBN:
9780387236049
Serie:
Cancer Treatment and Research 127
Inhalt:
First book to apply the concept of SSL to the majority of human cancers Revolutionary new concept that might significantly transform surgical cancer treatment Focuses on cancer metastasis and explores the biological frontier of micro metastasis Includes illustrations by experts in the field on how to successfully perform SSL
Inhalt:
In human solid cancer, the lymph node (LN) status is the most important prognostic indicator for the clinical outcome of patients. Recent developments in the sentinel lymph node (SLN) concept and technology have resulted in the application of this revolutionary approach to define the first draining or SLN to which the cancer may have metastasized. The underlying thesis in solid cancer biology is that metastasis generally starts in an orderly progression, spreading through the lymphatic channels to the SLN in the nearest LN basin. Thus, the logical approach is to harvest that specific SLN for thorough analysis. Because a tumorfree SLN is usually associated with a negative residual LN basin, a negative SLN is an excellent indication that micrometastasis has not occurred in the regional LNs. When the SLN is involved, it is unknown whether or not metastasis is limited only to the SLN or if the disease has spread to the remainder of the nodal basin. For this reason, if a SLN is positive, a complete lymph node dissection is recommended. Therefore, selective sentinel lymphadenectomy (SSL) should be considered as a staging procedure so that patients with negative SLNs (about 80%) may be spared an extensive LN dissection. Malignant melanoma has been proven to be the most ideal tumor model to study the role of SLN. Subsequently, SSL has been applied to breast cancer, colon cancer and other types of solid cancer. The multidisciplinary approach encompassing the surgeon, nuclear medicine physician, and pathologist is the key to such a successful procedure. Such a team can be formed readily with appropriate training. Beyond the technical aspects of harvesting the SLN, the implication of micrometastasis remains to be defined. Because the follow-up of melanoma and breast cancer patients after SSL is crucial, ongoing clinical trials are in progress to determine the biological and clinical significance of SLNs. Although the concept of SLN is viable in other types of cancer, such as gynecological and gastrointestinal, the technical aspects of the procedure need to be perfected and verified. The most exciting possibility of SSL is that it will lead to early diagnosis of micrometastasis in regional LNs. Early diagnosis makes it useful as a clinical staging procedure, and opens up new opportunities to study micrometastasis and its evolution within the SLNs. Examining the multifaceted aspects of micrometastasis, such as differentiation of different clones with respect to the primary tumor, acquisition of adhesion molecules, and host interaction with the microscopic tumor, will shed new light on the biology of early metastasis. New molecular and genetic tools may be used to dissect the mechanisms of lymphatic and hemo togenous routes of metastasis. If such mechanisms can be understood, new therapeutic advances may be developed to prevent the process of micrometastasis. Rather than targeting larger tumor burdens such as Stage IV disease, targeted adjuvant clinical trials can be developed for high risk patients following definit ive surgical resection. SSL is a standard staging procedure for patients with melanoma and is rapidly evolving into a standard procedure for breast cancer as well.
Anmerkung:
Includes bibliographical references and index
,
The Development of Lymphatic Mapping and Selective Lymphadenectomy; Role of Lymphoscintigraphy for Selective Sentinel Lymphadenectomy; Selective Sentinel Lymphadenectomy for Malignant Melanoma, Merkel Cell Carcinoma, and Squamous Cell Carcinoma; Selective Sentinel Lymphadenectomy for Breast Cancer; Sentinel Lymph Node Mapping in Colon and Rectal Cancer; Sentinel Lymph Node Mapping in Esophageal and Gastric Cancer; Sentinel Lymph Node Mapping in Lung Cancer; Lymphatic Mapping and Sentinel Lymphadenectomy in Urology; Selective Sentinel Lymphadenectomy for Gynecologic Cancer
,
Selective Sentinel Lymphadenectomy for Head and Neck Squamous Cell CarcinomaAccurate Evaluation of Nodal Tissues for the Presence of Tumor is Central to the Sentinel Node Approach; Molecular Diagnosis of Micrometastasis in the Sentinel Lymph Node; Credentialing of Nuclear Medicine Physicians, Surgeons, and Pathologists as a Multidisciplinary Team for Selective Sentinel Lymphadenectomy; Selective Sentinel Lymphadenectomy: Progress to Date and Prospects for the Future
Weitere Ausg.:
ISBN 9780387236032
Weitere Ausg.:
Buchausg. u.d.T. Selective sentinel lymphadenectomy for human solid cancer New York : Springer, 19XX ISBN 0387236031
Sprache:
Englisch
Fachgebiete:
Medizin
Schlagwort(e):
Krebs
;
Staging
;
Sentinel-Lymphknoten
;
Lymphknotenbiopsie
;
Krebs
;
Sentinel-Lymphknoten
;
Lymphknotenbiopsie
;
Metastase
;
Diagnose
;
Krebs
;
Staging
;
Sentinel-Lymphknoten
;
Lymphknotenbiopsie
;
Metastase
;
Diagnose
;
Aufsatzsammlung
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