Ex-vivo Methylene-blue perfusion of colon specimens to improve lymph-node harvest

Abstract

Aim: colon cancer prognosis is related to the number of surgically removed lymph-nodes. The aim of this study is to assess the efficacy of ex-vivo intra-arterial methylene-blue (MB) perfusion  of specimens after curative colon cancer surgery, to improve the number of harvested lymph-nodes. 

Method: Cohort, multi-centric study. A prospective (MB) study group was compared with a control, retrospective group. Demographics, stage, tumor site, specimen lenght and type of resection were assessed. Lymph-node count was the primary outcome.

Results: 76 patients were included, 29 in the study group and 47 in the control group. Median number of harvested lymph-nodes was 18 and 13 respectively (p=0,033).

Discussion: The number of harvested lymph-nodes varies according to patient, tumor, surgeon and pathologist-related factors. MB perfusion improved the median number of lymph-node count in the study group, as shown in the literature. Nevertheless, the minimum criteria of 12 nodes must be carefully examined together with these other factors.

Conclusions: We validated the efficacy of this technique, which is also simple, low-cost and easy to perform.