Özet:

Aim: Lymph node status in colon cancer (CC) is a major prognostic factor that determines the disease recurrence, survival, and the adjuvant treatment. Although sentinel lymph node (SLN) is an effective technique that improves pathologic assessment in breast cancer and melanoma, the feasibility and outcomes of SLN in CC is still controversial. Hence, we aimed to evaluate the sensitivity, specificity, and accuracy of SLN for determining lymph node status in CC. Method: A total of 84 consecutive patients undergoing urgent or elective colectomy for colon cancer were enrolled in this prospective randomized study. In vivo SLN mapping with blue dye was used to evaluate the lymph node status. The sensitivity of the method was evaluated by comparing the pathologic condition of 3-4 blue dyed lymph nodes with final conventional pathologic assessment. Results: The sensitivity of identification for SLN was low (61.54%) for predicting lymph node metastasis, false-negative rates were high (38.5%), specificity was 100%, the detection rate was 88.1%, the overall accuracy rate was 81.08% , negative predictive value 82.76%, and positive predictive value was 100% . No upstaging was determined in our study. Conclusion: Considering our results, SLN mapping could not predict the nodal status with clinically acceptable accuracy despite a high detection rate. We emphasize that en bloc tumor resection with regional lymph node dissection is still the standard treatment for CC. SLN mapping should not alter the extent of the operation due to its low predictive value.

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