Standard surgical staging for endometrial cancer is extrafascial hystrectomy, bilateral salpingo-oophorectomy with retroperitoneal lymph node dissection. Sentinel lymph node (SLN) biopsy allows the surgeon to selectively remove and analyze the most relevant nodes, thereby minimizing complications.
Herein we report the first two cases of laparoscopic SLN biopsy using near-infrared fluorescence (NIR) with indocyanine green (ICG) for endometrial cancer in the Philippines. Both cases were diagnosed with endometrial cancer, endometrioid type, confined to the corpus. Identified sentinel nodes were negative for metastasis on ultrastaging. Final histopathology of harvested nodes was negative. Peritumoral lymphovascular space invasion was identified only in the first case. Isolated lymphovascular space invasion appears to be a poor prognostic factor, even in the absence of lymph node metastasis and myometrial invasion.
Sentinel lymph node biopsy using ICG in laparoscopic staging for endometrial cancer is an easily performed and reproducible procedure in experienced hands. Standardization of histopathologic analysis of sentinel nodes should be implemented before adapting this method as standard of care in endometrial cancer.
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