• Ryungsa Kim, Manabu Emi, Kazuaki Tanabe, and Koji Arihiro.
• International Radiation Information Centre, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. rkim@hiroshima-u.ac.jp
• Lancet Oncol. 2006 Dec 1; 7 (12): 1006-16.

AbstractThe sentinel lymph node (SLN) is thought to be an important lymphoid organ for protecting against metastasis and is thought to play a crucial part in provoking antitumour immunity. Because SLN biopsy is undertaken for various types of cancers, such as malignant melanoma and breast cancer, SLN mapping has become a standard procedure, thereby eliminating unnecessary lymph-node resection in patients who do not have affected nodes. The immune surveillance activities of the SLN in melanoma and breast cancer are thought to be suppressed, whereas in cancers of gastrointestinal-tract, the presence of T cells in the SLN has not been shown to suppress the host's immune function. Furthermore, cell death after primary systemic chemotherapy for solid tumours can provoke an antigen-specific immunity in the tumour, which affects tumour response to treatment and, therefore, survival in patients. This review discusses the immunobiology of the SLN and potential strategies for activation of antitumour immunity by primary systemic chemotherapy and other modalities, in terms of tumour-size reduction and survival benefit.

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