Evidence map›Paper›PMID 29551004›Full record

ArticleTechniques in coloproctology2018

Feasibility of fluorescence lymph node imaging in colon cancer: FLICC.

M Chand, D S Keller, H M Joshi, L Devoto, M Rodriguez-Justo, R Cohen

Abstract read
PubMed Publisher
In one paragraph

Article in Techniques in coloproctology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 91 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Review
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Review
  18. Article
  19. Feasibility of indocyanine green (ICG) fluorescence inPathology oncology research : POR · 2024
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

M ChandDepartment of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, GENIE Centre, University College London, Charles Bell House, 43 Foley Street, London, W1W 7TS, UK. m.chand@ucl.ac.uk.
D S KellerDepartment of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, GENIE Centre, University College London, Charles Bell House, 43 Foley Street, London, W1W 7TS, UK.
H M JoshiDepartment of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, London, UK.
L DevotoDepartment of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, GENIE Centre, University College London, Charles Bell House, 43 Foley Street, London, W1W 7TS, UK.
M Rodriguez-JustoDepartment of Pathology, University College London Hospitals, NHS Foundation Trusts, London, UK.
R CohenDepartment of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, London, UK.
University College London · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn colon cancer, appropriate tumour excision and associated lymphadenectomy directly impact recurrence and survival outcomes. Currently, there is no standard for mesenteric lymphadenectomy, with a lymph node yield of 12 acting as a surrogate quality marker. Our goal was to determine the safety and feasibility of indocyanine green (ICG) fluorescence imaging to demonstrate lymphatic drainage in colon cancer in a dose-escalation study.

methodsA prospective pilot study of colon cancer patients undergoing curative laparoscopic resection was performed. At surgery, peritumoural subserosal ICG injection was done to demonstrate lymphatic drainage of the tumour. A specialized fluorescence system excited the ICG and assessed lymphatics in real time. The primary outcome was the feasibility of ICG fluorescent lymphangiography for lymphatic drainage in colon cancer. Secondary outcomes were the optimal protocol for dose, injection site, and ICG lymphatic mapping timing.

resultsTen consecutive patients were evaluated (six males, mean age 69.5 years). In all, lymphatic channels were seen around the tumour to a varying extent. Eight (80%) had drainage to the sentinel node. In all cases where the lymphatic map was seen, there was no further spread 10 min after injection. In 2 patients (20%), additional lymph nodes located outside of the proposed resection margins were demonstrated. In both cases the resection was extended to include the nodes and in both patients these nodes were positive on histopathology. Factors contributing to reduced lymphatic visualization were inadequate ICG concentrations, excess India ink blocking drainage, and inflammation from tattoo placement.

conclusionsICG can be safely injected into the peritumoural subserosal and demonstrate lymphatic drainage in colon cancer. This proof of concept and proposed standards for the procedure can lead to future studies to optimize the application of image-guided precision surgery in colon cancer. Furthermore, this technique may be of value in indicating the need for more extended lymphadenectomy.

Indexed as

AdultAgedColonic NeoplasmsFeasibility StudiesFemaleFluorescenceHumansIndocyanine GreenLaparoscopyLymphatic MetastasisLymph Node ExcisionLymph NodesLymphographyMaleMiddle AgedNeoplasm Recurrence, LocalIndocyanine GreenColectomyColon cancerComplete mesocolic excisionFluorescent Antibody TechniqueIndocyanine greenLymphangiographyOptical Imaging

Identifiers

PMID29551004
OpenAlexW2791858495

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.