A Medical Device Daily
According to the results of a recently completed multi-institutional clinical trial, patients with colorectal cancer who undergo sentinel lymph node mapping are less likely to have disease recurrence within five years of treatment. Findings from the study were presented at the 2006 Clinical Congress of the American College of Surgeons (ACS; Chicago), ongoing this week at Chicago’s McCormick Place.
After a follow-up of 63 months, the rate of recurrence of colorectal cancer was 7.8% in 165 patients who had sentinel lymph node mapping — a procedure that identifies the principal lymph nodes that drain fluid from a cancerous area and therefore may be the primary sites of minute metastases. The recurrence rate for 157 patients who did not undergo mapping was 24.8%.
The difference was “highly” statistically significant, the researchers said. The rate of local and regional recurrences of colorectal cancer was more than two times higher in patients who did not have sentinel lymph node mapping (24.3%) than in patients who underwent mapping (11%).
The researchers also found sentinel lymph node mapping to be a “highly accurate” method of staging colorectal cancer. The presence of disease was detected in more patients who had sentinel lymph node mapping (48%) than in patients who did not (34.7%). Sentinel lymph nodes were the exclusive site of metastasis in 41% of patients and harbored micrometastases in 26% of patients.
“By doing lymph node mapping, we can find minute [evidence of] cancer that we otherwise would not find,” said Sukamal Saha, MD, surgical oncologist at McLaren Regional Medical Center (Flint, Michigan). “By finding minute cancer in the lymph nodes, we can decide which patients need chemotherapy. We can also show that patients who have no cancer in the lymph nodes by lymphatic mapping will rarely develop a recurrence.”
The study included 500 patients with colorectal cancer who underwent sentinel lymph node mapping at one of three institutions: McLaren Regional Medical Center; Carson Cancer Center (Norfolk, Nebraska) and John Wayne Cancer Institute (Santa Monica, California). The analysis included all 500 patients who had sentinel lymph node mapping and 368 patients who did not. The analysis of disease recurrence included a subgroup of 322 patients followed for at least 18 months.
In other news from the congress:
• High-definition technology is moving from the home theater to the surgical suite. Just as HDTV enhances television color and clarity, high-definition imagery allows the medical community to see details of a patient’s anatomy with four times the resolution of standard-definition technology.
Sony Electronics , focused on aiding this transition, is debuting its “HD for Surgery” initiative at the ACS conference to show how its HD cameras, printers, monitors and “behind the scenes” technologies can enhance surgical images.
Steven Blum, Sony vice president of marketing and sales for medical products, said, “We have HD products and technologies that have become integral parts of medical systems from major surgical equipment manufacturers and integrators.”
As a demonstration showcasing the “HD for Surgery” theme, Sony is exhibiting several HD and HD-compatible products, including the LMD-1950MD flat panel monitor, UP-D75MD digital color printer, and the PDW-70MD, Sony’s first XDCAM HD medical-grade 1080i video recorder.
Included will be HD surgical footage acquired and shown using Sony products, plus live booth-to-booth medical education applications using Sony’s new PCS-HG90 IPELA high-definition, IP-based video communications system.
• 3M (St. Paul, Minnesota) introduced its Ioban 2 antimicrobial incise drape 6661EZ, an antimicrobial surgical drape designed with a “picture frame” delivery system. The 10.5-inch by 8-inch drape is “ideally suited for high-volume minimally invasive implant procedures,” the company said.
The new 6661EZ Ioban 2 drape is made with a “strong, conformable and breathable” polyester incise film coated with medical grade acrylate adhesive containing molecular iodine (Iz) as the active antimicrobial agent. The 6661EZ Ioban 2 drape provides a sterile surface to decrease bacterial contamination from skin to gloves, gowns, instruments and implants, the company said.
A drape’s barrier and antimicrobial properties are fully effective only when the drape is securely adhered to the patient’s skin. Clinical studies show that Ioban 2 incise drapes are designed to adhere better to skin than other drapes, especially after several hours, the company said.
• Neoprobe (Dublin, Ohio), a developer of oncology and cardiovascular surgical and diagnostic products, introduced a new gamma detection probe using Bluetooth wireless technology to communicate gamma radiation counts to the company’s neo2000 control unit.
The wireless probe eliminates cables that can complicate the surgical field and provides operative field flexibility. It is designed to be used with all existing models of the company’s neo2000 system (models 2000, 2100 and 2200).
The neo2000 line of gamma detection systems are “widely used” in a procedure called sentinel lymph node biopsy or intraoperative lymphatic mapping, the company said.