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Abstract
Introduction/Background Sentinel Lymph node-SLN biopsy is the gold standard lymph node status assessment in many gynecological tumors. Apparent early-stage ovarian cancer could be a perfect setting for the use of this technique as we previously demonstrated its feasibility. SLN detection allows to know more information with less morbidity for the patients.
Methodology Between December 2021–2023 patients with apparent early-stage ovarian cancer prospectively underwent intraoperative Indocyanine green fluorescence (ICG) for sentinel lymph node biopsy and subsequent ultrastaging followed by full staging surgery. The primary objective were to stablish the accuracy of ICG tracer to detection of sentinel lymph node and validate ultrastaging.
Results In total, 21 patients were included. The surgery indication was in 7 (33.3%) cases due to an adnexal masse and 14 (66.7%) for re-staging propose. Surgery was performed by laparoscopy in 90% of cases (19/21).
The mean age was 53 years (Range 46–61). Regarding the histologic features, 66.7% were high grade, The most frequent histotype were serous (52%), endometrioid (28%) and clear cell (20%).
The site of injection were the utero-ovarian (if present) and infundibulo-pelvic stumps. we used ICG tracer (0.2 ml; 1,25 mg/ml) and the injection technique described in SENTOV Trial. The global detection rate was 90% (19/21) being 83% (14/18) and 86% (18/21) for pelvic and para-aortic nodes respectively.
The final FIGO stage was IA in 38%, IC in 48%, IIB in 4.5% and IIIC in 9,5%. Two lymph node metastasis were found: one in sentinel lymph nodes after ultrastaging and the other in a patient with no SLN migration. 2 cases (13%) were up-staged due to positivity of peritoneal washing and other due to pelvic peritoneum involvement.
Conclusion Use of ICG tracer shows promising results for sentinel lymph node biopsy in early-stage ovarian cancer, especially in para-aortic nodes. A larger sample is needed to consolidate these results.
Disclosures None.
