Introduction This study aimed to assess the feasibility and effectiveness of using ICG to detect SLNs & to investigate how patient and tumor-related factors may influence this process in patients with endometrial and cervical cancer in low-middle income country like India.

Methods Patients with early stage cervical and endometrial cancer who underwent primary surgery with SLN identification using ICG Dye between July 2020 and March 2022 were analysed. Bilateral and overall SLN detection rates were calculated and univariate analysis was performed to estimate factors associated with SLN identification failure.

Results 49 patients with endometrial and cervical cancer were included in the study. Successful SLN identification was done in 46 out of 49 patients (93.87%).Unilateral and bilateral detection rate was 89.79% & 83.67% respectively. Sensitivity, Specificity, False Negative Rate, Accuracy of SLN identification using ICG dye was 83.33%, 95.34%, 16.67%, 93.87% respectively. Negative predictive value of this test was 97.6%. In our study, myometrial invasion in endometrial cancer( p = 0.44), LVI (with LVI p=0.12), Grade of tumor(higher grade, p = 0.26),menopausal status (postmenopausal, p = 0.09), tumor size (>4 cm,p=0.62), & Histopathology(adenocarcinoma, p = 0.157) have association with decrease SLNs identification, but it did not found statistically significance. Only BMI (>30) is found to be statistically significant to prove correlation between Obesity and SLN identification failure(p = 0.025).

Conclusion/Implications SLN identification using NIR fluorescence with ICG dye appears to be accurate method in our patients with early stage cervical or endometrial carcinoma. BMI is to be considered as an important factor for decrease SLN identification.