Introduction/Background Lymphadenectomy (LND) is essential when evaluating the stage and need for adjuvant treatment in endometrial cancer. However, its therapeutic value is still open. In cervical cancer, the role of LND in treatment selection is much more established. The aim of this study was to evaluate indocyanine green (ICG) and near infrared (NIR) fluorescence mapping used consecutively both in endometrial and cervical cancer.
Methodology This is a cohort study of patients with clinical stage I endometrial (n=178) and cervical (n=28) cancer undergoing robotic surgery (da Vinci Xi, Intuitive Surgery, Sunnyvale, CA, USA) in Kuopio University Hospital between February 2016 and 2019. ICG tracer (Verdye, 1.25 mg/ml) was injected in the cervix at the 3 and 9 o’clock positions submucosal and stromally.
Results SLN was detected bilaterally in 84% of the patients, and at least unilaterally in 86.4%. On pathologic evaluation, sentinel node included lymph node tissue in 98% of the cases. In 29 (14%) patients, SLN harbored metastasis. In endometrial and cervical cancer, the metastasis was observed in 13.3% and 18.5% of the cases, respectively. In those patients (n=124) having intermediate or high-risk disease and fit for completion lymphadenectomy, non-SLN harbored metastasis in eight patients (8%) although SLN did not. Accordingly, the false negative rate was 25%. The SLN was the only metastatic node in twelve patients (12%). Sensitivity to detect node-positive disease was 78.4%(95% CI 61.8–90.2%) and a negative predictive value was 91.8% (95% CI 85.9–95.4%).
Conclusion SLN detection using ICG proved to be feasible and accurate. The results correlate with previous single institution studies and meta-analyses.
Disclosure Nothing to disclose.
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