Trial Information

Dynamic In Vivo Lymphography and Sentinel Node Biopsy in Colorectal Cancer: A Feasibility Study

OBJECTIVES: I. Confirm that injection of isosulfan blue into the mucosa or serosa
immediately adjacent to a colorectal cancer results in the lymphatic transport of that agent
initially to a specific regional lymph node that can readily be identified on visual
inspection, dissected, and histologically evaluated for the presence or absence of
metastatic disease.

OUTLINE: All patients receive an injection of isosulfan blue into peritumor serosa upon
intraoperative identification of the primary tumor, prior to mesenteric mobilization. If
colonoscopy is otherwise indicated, the injection may be delivered to the peritumor mucosa
via colonoscopy during the case. The mesentery adjacent to the injection is inspected and
the lymphatic pattern and nodes demonstrated by the isosulfan blue are diagrammed and
photographed. The sentinel node(s) are surgically dissected and evaluated. If needed, a
second injection of isosulfan blue may be given. Prior to mobilization of liver for
resection of metastases, isosulfan blue is injected subcapsularly around the metastatic
lesion.

PROJECTED ACCRUAL: There will be 10 patients accrued into this study.