Introduction/Background Sentinel lymph node (SLN) mapping with indocyanine green (ICG) is used for nodal staging in patients with endometrial cancer for last 10 years. Many authors showed the efficiency of using ICG in SLN mapping in endometrial cancer.
As part of surgical management in endometrial cancer, bilateral pelvic lymphadenectomy is considered standard of care. However, pelvic lymphadenectomy is associated with complications, such as lymphedema, the risk of nerve injury, and lymphocyst formation.
Methodology From January 2016 to March 2018 in single-center study, 100 patients with endometrial cancer IA-IB stages underwent laparoscopic surgery using ICG for SLN mapping.
A unit of 4 cc of this ICG solution was injected into the cervix alone divided into the 3- and 9-o´clock positions, with 1 cc deep into the stroma and 1 cc submucosally on the right and the left of the cervix.
Results Overall detection rate of SLNs registered in 99/100 patients (99.0%), bilateral - 95/100 (95.0%). Only in one patient SLNs were not detected -1/100(1%).
Lymph node metastatic disease identified in 11/100 patients (11.0%). All metastasis identified in SLNs.
The most frequent localization of SLN was in internal lymphatic group 94/220 (46%).
Diagnostic efficiency of the SLN biopsy: sensitivity - 100.0%, specificity -93.0%, accuracy - 93.0%, false-negative results - 0%.
In the high risk group of metastasis, metastasis were detected in 6/100 (6%) patients.
In the intermediate group and low risk group - SLN metastasis were identified in 5/100 (5%) patients. No metastatic disease was identified in non SLN.
In the case of absence of metastases in SLNs 88/99 (89%), all non-SLNs were intact.
Conclusion SLN detection with ICG in patients with endometrial cancer IA-IB stages is an effective diagnostic fluorescence method. Overall and bilateral detection rate of SLN visualization is high, which allows removing the detected SLNs, making frozen-section and individualizing the treatment.
Disclosure Nothing to disclose.
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