RATIONALE: Diagnostic procedures, such as lymph node mapping and biopsy, may improve the
ability to detect the extent of colorectal cancer.
PURPOSE: Diagnostic trial to study the feasibility of lymph node mapping and sentinel lymph
node biopsy in patients who have stage I, stage II, or stage III colorectal cancer.
OBJECTIVES: I. Determine the feasibility of lymphatic mapping and sentinel lymph node biopsy
in patients with stage I, II, or III colorectal cancer. II. Evaluate technetium Tc 99m
sulfur colloid as a mapping agent in this patient population. III. Identify patients with
histologically negative nodes but have positive nodes on further detailed examination.
OUTLINE: Patients undergo preoperative endoscopy with injection of technetium Tc 99m sulfur
colloid around tumor followed by celiotomy and intraabdominal exploration. At 30 minutes
following injection, patients undergo lymphatic mapping with a gamma probe and biopsy of the
sentinel lymph node(s). Following biopsy and mapping, patients undergo resection of primary
tumor. Patients are followed postoperatively, every 4-6 months for 2 years, every 6 months
for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 10 patients will be accrued for this study within 2 years.
DISEASE CHARACTERISTICS: Preoperative diagnosis of stage I, II, or III colorectal cancer
No more than 90 days since diagnosis No tumor involving adjacent structures (T4 lesion) No
clinical or radiological evidence of stage IV disease No total excision of primary tumor
PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 60-100% Life
expectancy: Not specified Hematopoietic: Not specified Hepatic: No severe decompensated
liver disease, including cirrhosis Renal: Not specified Other: No known primary or
secondary immunodeficiencies No other medical conditions or evidence of infection that
would preclude study Not pregnant Negative pregnancy test
PRIOR CONCURRENT THERAPY: See Disease Characteristics No prior colonic, aortic, or