Evidence map›Paper›PMID 40183956›Full record

Trial reportEuropean journal of nuclear medicine and molecular imaging2025

Prospective clinical study of sentinel node detection in bladder cancer using a hybrid tracer - Towards replacement of pelvic lymph node dissection in cases with sentinel node visualization on SPECT/CT?

E J van Gennep, G Pisano, G H KleinJan, D D D Rietbergen, K Hendricksen, L S Mertens, M W Vd Kamp, E M K Wit, M L van Montfoort, M Donswijk and 3 more

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of nuclear medicine and molecular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

E J van GennepDepartment of Urology, Leiden University Medical Center, Leiden, The Netherlands.
G PisanoInterventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
G H KleinJanDepartment of Urology, Leiden University Medical Center, Leiden, The Netherlands. g.h.kleinjan@lumc.nl.
D D D RietbergenInterventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
K HendricksenDepartment of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
L S MertensDepartment of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
M W Vd KampDepartment of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
E M K WitDepartment of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
M L van MontfoortDepartment of Pathology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
M DonswijkDepartment of Nuclear Medicine, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
B W G van RhijnDepartment of Urology, Leiden University Medical Center, Leiden, The Netherlands.
F W B van LeeuwenInterventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
H G van der PoelDepartment of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Funding

KWF Kankerbestrijding PGF2009-4344
6 · The paper itself

Abstract

purposeNodal staging in patients with muscle invasive bladder cancer (MIBC) or very high risk non-muscle invasive bladder cancer (vhNMIBC) aids to predict survival. The sentinel node (SN) procedure holds the promise to identify the diagnostically relevant first tumor-draining nodes while limiting the complication rate associate with a pelvic lymph node dissection (PLND), still considered the gold standard of nodal staging. Following an initial technical feasibility study, we prospectively evaluated the clinical impact of using peri-tumoral injections with the hybrid tracer indocyanine green (ICG)-

methodsA total of 30 patients with vhNMIBC or MIBC, cN0M0 (with or without neo-adjuvant systemic therapy) scheduled for radical cystectomy with pelvic lymph node dissection (PLND) were enrolled in a prospective study. Patients received four to six transurethral peritumoral injections of ICG-

resultsSPECT/CT imaging revealed 31 SNs in 19 patients with non-visualization of SN in 11 patients (36.7%). During surgery, 4 additional SNs were identified based on fluorescent signals in 3 patients. In 1 patient who underwent open cystectomy, ex vivo evaluation of the PLND-specimen revealed an additional radioactive SN. The PLND yielded 592 lymph nodes (LNs; median 17 LNs/patient). In 5 out of 35 SNs (14.2%; no additional tumor positive LN in complementary PLND) and 3 out of 592 LNs (0.5%; 2 patients with non-visualization of SN) were identified as tumor-positive upon pathological evaluation. At mean follow up of 82 months (SD ± 7.1 months) 17% of patients died of disease. The 2 patients with non-visualization of SN and nodal metastases (0%) did worse than SN positive patients (75%). Of the 24 patients classified as pN0 8% died.

conclusionsPreoperative SN-visualization on SPECT/CT was achieved in the majority of patients. Patients with SN non-visualization had an increased risk of nodal metastases and poorer outcome. In patients with metastases in the SN no additional nodal metastases were found in the complementary PLND.

Indexed as

Lymph Node ExcisionSentinel Lymph NodeSentinel Lymph Node BiopsySingle Photon Emission Computed Tomography Computed TomographyUrinary Bladder NeoplasmsAgedAged, 80 and overFemaleHumansIndocyanine GreenLymphatic MetastasisMaleMiddle AgedPelvisProspective StudiesRadioactive TracersIndocyanine GreenRadioactive TracersTechnetium Tc 99m Aggregated AlbuminBladder cancerFluorescenceRadio-guided surgeryRobotic surgerySentinel lymph node

Identifiers

PMID40183956
PMCPMC12316797

What OpenQuestion holds

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Registered trials

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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.