P21 Presentation of multicentric trial about sentinel node identification with sentinella intraoperative gamma camera versus traditional gamma probe

Résumé fourni par la source

Melanoma presents a strong concept of a locoregional disease, which is supported by the natural history, characterised by a progressive but not definitive worsening of the prognosis as the disease, from the primary lesion, diffuses to the nodes and then to the rest of the body. In fact, when the disease has involved the locoregional nodes, it not always spreads systemically. In this contest the proposal of sentinel lymph node biopsy (SNB) suggested to melanoma patients acquires a strong prognostic significance. Sentinel lymph node (SN) dissection is a minimally invasive procedure designed to identify and remove specific lymph nodes suspected of containing metastatic cancer cells. Clinical trials have demonstrated that excision and histologic inspection of the SN is highly predictive for the absence of metastatic disease in melanoma patients, if the SN is free of tumor cells. The more efficient method to perform SNB is by using radioactive colloid traced. The surgeon uses a hand-held gamma probe intraoperatively to identify lymph nodes likely to contain metastases from the primary lesion. So far, any improvement in sentinel lymph node detection technique has great potential benefit for patients and research. Sentinella(r) is a surgical suite composed of a portable gamma camera with laser pointing system a touch screen monitor, a software which allows to process the acquired images and to generate medical reports, traditional hand held gamma probe and an exclusive Gadolinium pointer. In our institution we performed 68 SNB using the Seninella(r) suite machinery in the last year with 100% node identification and excision rate. We are actually presenting a study to evaluate if the use of Seninella(r) device will improve the accuracy in locating the sentinel node. The primay endpoint of this trial is to evaluate of the number positive sentinel nodes identified using the intraoperative gamma camera, vs using only the traditional intraoperative probe and if this aspect may influence the false negative SN rate. Furthermore, cost-benefit analysis of this approach will be considered.

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