THE EFFECTIVENESS OF CARBON NANOPARTICLES AS LYMPH NODE TRACERS IN COLORECTAL CANCER LYMPHADENECTOMY: A SYSTEMATIC REVIEW

Abstract

Background: Colorectal cancer (CRC) is the third most common malignancy in the world, claiming at least 881,000 lives in a year. Despite numerous treatment options developed in recent years, surgical resection remains the treatment of choice. Considering possible metastasis to nearby lymph nodes, sufficient lymphadenectomy is an important prognostic factor and critical for accurate staging. However, number of lymph nodes harvested is often inadequate. Carbon nanoparticles has recently emerged as an excellent method of lymph node tracer in CRC. Yet, reviews regarding its effectiveness is still lacking.
Aim: To evaluate the effectiveness of carbon nanoparticles in detecting lymph nodes and improving staging accuracy for colorectal cancer.
Method: A systematic review was conducted through PubMed, Scopus, EBSCOhost, and Cochrane, searching for studies implementing carbon nanoparticles in detecting lymph nodes during surgical resection of CRC. Quality assessments of studies selected were performed with selected risk-of-bias assessment tools.
Outcome: The search yielded 10 studies with a total of 1387 subjects. Carbon nanoparticles were effective in increasing the total number of harvested lymph nodes and improving the ability of detecting smaller lymph nodes of <5 mm. Number of positive lymph nodes did not differ significantly with controls; however, carbon nanoparticles effectively improved staging accuracy, thereby signifying a reduction in risk of understaging. Moreover, operative time and blood loss were reduced in comparison to conventional methods. No significant adverse effects were reported.
Conclusion: To conclude, carbon nanoparticles showed promising potentials as lymph node tracer to help improve harvest and staging accuracy in CRC patients.