Objective: To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial.
Summary Background Data: The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training phase of surgeons performed by a group of core surgical trainers. The goals of this training phase were to expeditiously instruct surgeons in a standardized technique of sentinel lymph node biopsy and to educate those same surgeons in complete and accurate data collection and source documentation for the trial.
Methods: This study is a description of the training data collected in a prospective fashion for the training component for surgeon entry into the B32 trial, evaluating the effectiveness of the training program in regards to surgical outcomes and protocol compliance.
Results: Two hundred twenty-six registered surgeons underwent site visit training by a core surgical trainer and 187 completed training and were approved to randomize patients on the trial. The results of 815 training (nontrial) cases demonstrated a technical success rate for identifying sentinel nodes at 96.2% with a false negative rate of 6.7%. A protocol compliance analysis, which included the evaluation of 94 separate fields, showed mean protocol compliance of 98.6% for procedural fields, 95.5% for source documentation fields and 95.0% for data entry fields.
Conclusions: This training and quality control program has resulted in a large number of surgeons capable of performing sentinel lymph node biopsy in a standardized fashion with a high degree of protocol compliance and pathologic accuracy. This will ensure optimal results for procedures performed on the randomized phase of the trial.
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http://dx.doi.org/10.1097/01.sla.0000149429.39656.94 | DOI Listing |
J Small Anim Pract
January 2025
Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
Objectives: The aim of this prospective study was to assess the association between methylene blue staining pattern and the presence of histologic nodal metastasis in dogs with low-grade mast cell tumour in low-resource settings for the efficient diagnosis of lymphatic spread.
Methods: Dogs with a single, cytologically low-grade mast cell tumour and no documented distant metastases were prospectively included and underwent surgery. Along with primary mast cell tumour removal, intraoperative sentinel lymph node mapping with peritumoral mast cell tumour injection and regional lymph node excision, regardless of whether blue dye was visible in the lymph node, were performed.
Dermatitis
January 2025
From the Department of Allergy and Clinical Immunology, Unidade Local de Saúde de São João, Porto, Portugal.
Patent Blue V (PBV) is extensively used in sentinel lymph node identification in cancer surgery, potentially leading to an increased incidence of hypersensitivity reactions. A retrospective analysis was conducted on patients with suspected PBV hypersensitivity, at our center from 2010 to 2023. Skin prick tests (SPT) were performed on all patients, followed by intradermal tests (IDT) if SPT was negative.
View Article and Find Full Text PDFCurr Opin Oncol
January 2025
Department of Medical Oncology, Institut Jules Bordet - Université Libre de Bruxelles (ULB).
Purpose Of Review: This review aims to explore the evolving management strategies for stage III melanoma, focusing on the comparative effectiveness of traditional surgical approaches like complete lymph node dissection (CLND) versus modern adjuvant therapies. It also examines the latest evidence on the efficacy, risks, and complications of these strategies, emphasizing the role of shared decision-making between patients and clinicians.
Recent Findings: Recent clinical trials and meta-analyses, including the MSLT-II and DeCOG-SLT studies, have demonstrated that CLND may not significantly improve survival outcomes in melanoma patients with sentinel lymph node biopsy (SLNB)-positive status.
AME Case Rep
November 2024
Department of Clinical Laboratory Diagnosis, Shijiazhuang Pingan Hospital, Hebei Medical University, Shijiazhuang, China.
Background: Primary breast squamous cell carcinoma (PBSCC) is a unique histopathological type of breast cancer. The majority of current case reports of PBSCC are triple-negative tumors with poor prognosis. Due to its heterogeneous clinical course, no unified management is achieved.
View Article and Find Full Text PDFExp Dermatol
January 2025
Department of Dermatology, Kansai Medical University, Hirakata, Osaka, Japan.
Chronic inflammation in the tumour microenvironment (TME) via Th2-polarisation promotes melanoma progression and metastasis, making it a target for immunotherapy. Interleukin (IL)-4 is considered essential for Th2-polarisation in the TME; however, its source remains unknown. Basophils have been postulated as one of its sources.
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