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Sentinel node detec...
Sentinel node detection in muscle-invasive urothelial bladder cancer is feasible after neoadjuvant chemotherapy in all pT stages, a prospective multicenter report
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Rosenblatt, Robert (författare)
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Johansson, Markus (författare)
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Alamdari, Farhood (författare)
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Sidiki, Alexander (författare)
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Holmström, Benny (författare)
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Hansson, Johan (författare)
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Vasko, Janos (författare)
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Marits, Per (författare)
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Gabrielsson, Susanne (författare)
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Riklund, Katrine (författare)
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Winqvist, Ola (författare)
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Sherif, Amir (författare)
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- 2017
- 2017
- Engelska.
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Ingår i: World journal of urology. - 0724-4983. ; 35:6, 921-927
Abstract
Ämnesord
Stäng
- PURPOSE: To determine whether sentinel node detection (SNd) in muscle-invasive urothelial bladder cancer (MIBC) can be performed in patients undergoing neoadjuvant chemotherapy (NAC) and determine whether SNd is feasible in all pT stages, including pT0. BACKGROUND: Previous published series of SNd in MIBC have not included patients undergoing NAC, and systematic reports of pT0 patients w/wo NAC were absent. Translational immunological tumor research on MIBC focusing on SNd, in the era of NAC, requires technical feasibility. Additionally, SNd in MIBC requests further evaluations as a method for nodal staging. MATERIALS AND METHODS: Ninety-nine patients with suspected urothelial MIBC were prospectively selected from six urological centers. After TUR-B and primary staging, 65 MIBC patients qualified for radical cystectomy. Precystectomy staging was cT2a-T4aN0M0, including 47 NAC patients and 18 chemo-naïve patients. All 65 patients underwent intraoperative SNd by peritumoral injection of 80 Mbq Technetium and Geiger probe detection. Postcystectomy staging was pT0-T4aN0-N2M0. SNs were defined by two calculations, SNdef1 and SNdef2. RESULTS: Totally 1063 lymph nodes were removed (total SNs; 222-227). NAC patients with pT0 (n = 24) displayed a true positive detection in 91.7 % by either SNdef, with a median of 3.0 SNs. NACpT >0 patients had a true positive detection in 87 % (SNdef1) and 91.3 % (SNdef2). In a univariate analysis, patient group neither NAC nor tumor downstaging influenced detection rates, regardless of SN definition. In total eight patients, 4/22 metastatic nodes were SNs while 18/22 were non-SNs. CONCLUSIONS: Sentinel node detection in MIBC is feasible also in NAC patients, regardless of pT stage. SNd played no role in nodal staging.
Ämnesord
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Urology and Nephrology (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Urologi och njurmedicin (hsv)
Nyckelord
- Urinary bladder neoplasms
- Neoadjuvant therapy
- Cisplatin
- Sentinel lymph node biopsy
- Cystectomy
- Immunotherapy
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Rosenblatt, Robe ...
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Johansson, Marku ...
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Alamdari, Farhoo ...
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Sidiki, Alexande ...
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Holmström, Benny
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Hansson, Johan
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Vasko, Janos
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Marits, Per
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Gabrielsson, Sus ...
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Riklund, Katrine
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Winqvist, Ola
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Sherif, Amir
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