Sentinel lymph node detection in anal cancer: A feasibility study of indocyanine green fluorescence and conventional blue dye/radiocolloid mapping
Mr Justin Davies, Consultant Colorectal Surgeon
Addenbrokes Hospital, Cambridge
Co-researchers: Miss Nicola Fearnhead, Dr Charles Wilson, Mr Peter Baldwin, Professor Gordon Wishart, Mr Amer Durrani,
Project summary
Anal cancer is a painful, debilitating and potentially fatal disease. About 850 new cases are diagnosed in the UK each year. The treatment of choice is chemotherapy and radiotherapy; surgery is reserved for when the disease recurs or does not fully respond.
In a minority of anal cancer patients cancer cells spread to the lymph glands of the groin, but we currently have no accurate way to test for this. Therefore, all patients have to receive radiotherapy treatment to the groin although the majority of them do not need it. Groin radiotherapy can cause a variety of serious complications and side-effects.
In patients with recurrent disease being considered for surgery, if it was known at that time that cancer cells were present, then relevant glands in the groin could be removed during surgery to give a better chance of cure.
This study will first assess how accurate a method (sentinel lymph node detection - SLND) traditional in other cancers of detecting whether cancer cells have spread to the lymph glands is in patients with anal cancer. Second it will compare the traditional method with a newer, easier and potentially safer technique that does not involve exposure to radiation.
We will assess how well each of the techniques works in patients with anal cancer. This will allow a more focused and individualised treatment for newly diagnosed patients who do have spread of cancer cells to the lymph glands in the groin. The majority of patients currently overtreated can then be spared the significant potential complications of groin radiotherapy.
Further, in patients with recurrent disease, we will be able to offer a better chance of cure if all residual cancer is removed at the time of surgery, including the groin lymph glands if SLND shows them to be involved. Finally, comparison of different SLND techniques may allow a more reliable, safer and easier method to be developed.
This page was last updated on 12-11-2010