"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”
A study looking at finding which lymph nodes bowel cancer cells travel to first
We know that this is an especially worrying time for people with cancer and their family and friends. We have separate information about coronavirus and cancer. Please read that information alongside this page. We will update that information as guidance changes.
This study tested a dye and special camera to see how well they show up the lymph nodes that bowel cancer cells travel to first.
More about this trial
Surgery is the most common treatment for colon cancer (bowel cancer). The cancer can spread to the lymph nodes, but doesn’t always. It is difficult to tell which lymph nodes contain cancer cells, so surgeons often remove all the nearby nodes. Removing them all can make the operation longer and more complicated.
The research team want to find a way to identify the lymph nodes most likely to contain cancer cells. These are called sentinel lymph nodes (SLN).
In this study they injected a green dye called ICG into the cancer during surgery. They then used a special camera (called near infra red or NIR) to see which nodes the dye had gone to. These nodes were removed to be examined in the lab. The surgeon then removed the cancer and the rest of the lymph nodes as usual.
The main aim of this study was to see if using this dye and camera could identify the sentinel lymph nodes.
Summary of results
This study recruited 30 people who were due to have surgery to remove their colon cancer.
The research team had planned to only recruit people whose cancer was within the inner layer or muscle layer of the bowel (stage T1 or T2 cancer). But when they did the operations, they found that some of the cancers had grown into the outer lining or through the wall of the bowel (stage T3 or T4 cancer).
The researchers were able to identify the sentinel lymph nodes in 27 out of 30 people who took part.
Of these 27 people, laboratory tests showed that 9 people had cancer that had spread to the lymph nodes. But only 3 of the sentinel lymph nodes identified in this study contained cancer cells. So 6 of the results were negative when they should have been positive (false negative results). This is quite high, but it is difficult to draw any firm conclusions as it was a small study.
Out of the 6 people with a false negative result:
- 4 had stage T3 or T4 cancer that had grown into the outer lining or through the wall of the bowel
- 5 had cancer that was larger than 35mm
The research team think that this method may be more accurate in people with:
- stage T1 or T2 cancer that is in the inner layer or muscle layer of the bowel, or
- cancer that is less than 35mm
The research team concluded that using ICG dye and a near infra red camera was useful detect sentinel lymph nodes in people with colon cancer. But that it wasn’t a good way to identify which ones contained cancer cells. They suggest that using two different types of dye at the same time may work better.
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.
How to join a clinical trial
Professor Robin Kennedy
Imperial College London
London North West Healthcare NHS Trust
St Mark’s Hospital Foundation
St Mark’s Hospital and Academic Institute
The Barcapel Foundation
The Savvas Regas Foundation