Lymphadenectomy


Lymphadenectomy

Lymphadenectomy consists of the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer.

This is usually done because many types of cancer have a marked tendency to produce lymph node metastasis early on in their natural history. This is particularly true of melanoma, head and neck cancer, differentiated thyroid cancer, breast cancer, lung cancer, gastric cancer and colorectal cancer. Famed British surgeon Sir Berkeley Moynihan once remarked that "the surgery of cancer is not the surgery of organs; it is the surgery of the lymphatic system".

The better known examples of lymphadenectomy are "axillary lymph node dissection" for breast cancer; "radical neck dissection" for head and neck cancer and thyroid cancer; "D2 lymphadenectomy" for gastric cancer; and "total mesorectal excision" for rectal cancer.

More recently, the concept of sentinel lymph node mapping has been popularized by Dr. Donald Morton and others. Cancer with various primary sites, breast, melanoma, colorectal, etc, often metastasize early to the first drainage lymphatic basin. This process is predictable anatomically according to the primary site in the organ and the lymphatic channels. The first nodes (sentinel nodes) can be identified by particulate markers such as lymphazurin, methylene blue, india ink and radio-labelled colloid protein particles injected near the tumor site. The draining sentinel node can then be found by the surgeon and excised for verification by the pathologist if tumor cells are present, and often these tumor cells are few and only easily recognized by careful examination or by using techniques such as special stains, i.e. immunohistochemical. When the sentinel node is free of tumor cells, this is highly predictive of freedom from metastasis in the entire lymphatic basin, thus leading to futility of a full node dissection.

The practice of sentinel lymph node mapping has changed the surgical approach in many cancer systems, sparing a formal lymph node dissection for patients with sentinel lymph node negative for tumor and directing a full node dissection for patients with sentinel lymph node positive for tumor metastases. For example in stage II breast carcinoma, using the sentinel lymph node technique, 65% of patients could be spared from a formal node dissection.


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Look at other dictionaries:

  • lymphadenectomy — A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. For a regional lymphadenectomy, some of the lymph nodes in the tumor area are removed; for a radical lymphadenectomy, most or all of the… …   English dictionary of cancer terms

  • lymphadenectomy — /lim fad n ek teuh mee, lim feuh dn /, n., pl. lymphadenectomies. the excision of one or more lymph nodes, usually as a procedure in the surgical removal or destruction of a cancer. [LYMPH + ADEN + ECTOMY] * * * …   Universalium

  • lymphadenectomy — noun The surgical removal of lymph nodes, usually performed as part of the management of cancer …   Wiktionary

  • lymphadenectomy — Excision of lymph node s. [lymphadeno + G. ektome, excision] * * * lymph·ad·e·nec·to·my .lim .fad ən ek tə mē n, pl mies surgical removal of a lymph node * * * lym·phad·e·nec·to·my (lim fad″ə nekґtə me) [lymphaden + ectomy]… …   Medical dictionary

  • lymphadenectomy — n. surgical removal of lymph nodes, an operation commonly performed when a cancer has invaded nodes in the drainage area of an organ infiltrated by a malignant growth …   The new mediacal dictionary

  • lymphadenectomy — /lim fad n ek teuh mee, lim feuh dn /, n., pl. lymphadenectomies. the excision of one or more lymph nodes, usually as a procedure in the surgical removal or destruction of a cancer. [LYMPH + ADEN + ECTOMY] …   Useful english dictionary

  • Лимфаденэктомия (Lymphadenectomy) — хирургическая операция, заключающаяся в иссечении лимфатических узлов; обычно она выполняется в случае поражения лимфатических узлов злокачественными клетками в результате образования в организме человека метастазов. Источник: Медицинский словарь …   Медицинские термины

  • retroperitoneal lymphadenectomy — surgical removal of lymph nodes in the retroperitoneal space, usually because of cancer metastasis, such as from carcinomas of the genital organs in men. Called also retroperitoneal lymph node dissection (RPLND) …   Medical dictionary

  • pelvic lymphadenectomy — Surgery to remove lymph nodes in the pelvis for examination under a microscope to see if they contain cancer …   English dictionary of cancer terms

  • lymph node dissection — lymphadenectomy …   Medical dictionary