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Comparison between Preoperative Versus Intraoperative Injection of Technetium-99 m Neomannosyl Human Serum Albumin for Sentinel Lymph Node Identification in Early Stage Lung Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

We aimed to evaluate the results of sentinel lymph node mapping according to injection time (preoperative vs. intraoperative) of technetium-99m neomannosyl human serum albumin (99mTc-MSA) in patients with lung cancer.

Methods

Data of 82 patients (55 men; mean age 62.9 ± 9.3 years) who were candidates for lobectomy with mediastinal lymph node dissection for clinical stage I non–small cell lung cancer were retrospectively reviewed. 99mTc-MSA was administered at the peritumoral region under chest computed tomographic guidance, 1 to 2 h before surgery (preoperation group, n = 48) or soon after thoracotomy (intraoperation group, n = 34).

Results

Patients’ demographic data, except type of operation, did not differ between the two groups. Sentinel lymph nodes were detected in 46 patients (95.8%) in the preoperation group and 33 patients (97.1%) in the intraoperation group (P = .243). The mean number of sentinel nodes per patient was 2.1 in the preoperation group and 2.6 in the intraoperation group (P = .068). No falsely negative sentinel nodes were detected in any of the 17 patients with N1 or N2 disease (0%) in either group. Administration of the intraoperative injection could save additional cost (US$607) and time (70 min) in each patient.

Conclusions

Sentinel node identification using 99mTc-MSA appears to provide similar excellent results in both preoperative and intraoperative injection. Therefore, intraoperative injection of 99mTc-MSA may be preferred as a result of lower cost and less waste of time.

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Acknowledgment

Supported by a grant of the Korean Health Technology R&D Project, Ministry of Health, Welfare and Family Affairs, Republic of Korea (A070001).

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea

    Hyun Koo Kim MD, PhD, Ho Kyung Sung MD & Young Ho Choi MD, PhD

  2. Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea

    Sungeun Kim MD, PhD

  3. Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea

    Yun-Sang Lee PhD & Jae Min Jeong PhD

Authors
  1. Hyun Koo Kim MD, PhD
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  2. Sungeun Kim MD, PhD
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  3. Ho Kyung Sung MD
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  4. Yun-Sang Lee PhD
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  5. Jae Min Jeong PhD
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  6. Young Ho Choi MD, PhD
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Correspondence to Hyun Koo Kim MD, PhD.

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Kim, H.K., Kim, S., Sung, H.K. et al. Comparison between Preoperative Versus Intraoperative Injection of Technetium-99 m Neomannosyl Human Serum Albumin for Sentinel Lymph Node Identification in Early Stage Lung Cancer. Ann Surg Oncol 19, 1343–1349 (2012). https://doi.org/10.1245/s10434-011-2130-4

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  • DOI: https://doi.org/10.1245/s10434-011-2130-4

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