Table 9. Proportions of cases with positive sentinel nodes only, no other positive lymph nodes (Giuliano et al. 1995)

T1 = 100%

T2 = 70%

T3 = 26%

T4 = 20%

tive non-SLNs for examination in sentinel node-negative cases. When the investigations published by Tsioulias et al. (2000) were repeated by Wiese et al. (1999) in 75 cancer cases with 354 investigated nodes positive, nonsentinel nodes in SLN-negative cases were found in only 0.6%.

The distribution of cases with only positive SLNs and no other positive regional lymph nodes by stage of primary in Tsioulias et al.'s (2000) publication, reflecting to the results of Giuliano's group (1995) in breast cancer study-programs is summarized in Table 9.

This means that in higher T-stages according to blockade of lymphatics cancer cells are also drained to other basins.

The topographical evaluations in the different sites of primaries demonstrate that the SLN concept with documentation of aberrant locations of nodes involved early provide very impressive evidence that the SLN concept is a highly relevant factor in prospective improvements in the outcome of our patients with cancers in the gastrointestinal tract also. The high rate of locoregional recurrence demands serious improvement of locoregional tumor clearance supported by the sentinel node search.

Improvements are also related secondarily to our adjuvant chemotherapy concepts.

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