Selective sentinel lymphadenectomy for human solid cancer

Lymph node (LN) status is the most important prognostic indicator for the clinical outcome of patients in human solid cancer. Recent developments in sentinel lymph node (SLN) concept and technology have resulted in the application of this revolutionary approach to determine if cancer has metastasized. The underlying thesis in solid cancer biology is that metastasis generally starts in an orderly progression, often spreading through the lymphatic channels to the SLN. Thus, the logical approach is to harvest that specific sLN for thorough analysis. The mist exciting possibility of selective sentinel lymphadenectomy (SSL) is that it will lead to early diagnosis of micrometastasis in regional LNs. New molecular and genetic tools may be used to dissect the mechanisms of lymphatic and hemotogenous routes of metastasis. If such mechanisms can be understood, new therapeutic advances may be developed to prevent the process of micrometastasis.