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#1098 Prospective observational study on sentinel node biopsy using two concurrent labelling techniques (Radioactive tracer with/without blue dye vs. indocyanin green-ICG) in early-stage endometrial cancer patients (TESLA–1) (CEEGOG EX-02)
  1. Maja Pakiz1,
  2. David Cibula2,
  3. Dariusz Grzegorz Wydra3,
  4. Jaroslav Klat4,
  5. Michal Zikan5,
  6. Renata Poncova2,
  7. Anna Abacjew-Chmylko3,
  8. Andraz Dovnik1,
  9. Martina Romanova4,
  10. Filip Freuhauf2,
  11. Sambor Sawicki3,
  12. Andrej Cokan1,
  13. Roman Kocian2,
  14. Zuzanna Mascianica3,
  15. Leyla Al Mahdawi1,
  16. Lukas Dostalek2,
  17. Paulina Zygowska3,
  18. Jiri Slama2,
  19. Radoslaw Owczuk6 and
  20. Jure Knez1
  1. 1Department for Gynecologic and Breast Oncology, University Medical Center Maribor, Maribor, Slovenia
  2. 2Department of Obstetrics, Gynecology and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
  3. 3Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, Gdansk, Poland
  4. 4Department of Obstetrics and Gynecology, University Hospital and University of Ostrava, Ostrava, Czech Republic
  5. 5Department of Gynecology and Obstetrics, Charles University – First Faculty of Medicine and University Hospital Bulovka, Prague, Czech Republic
  6. 6Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Gdansk, Poland


Introduction/Background Sentinel lymph node biopsy (SNB) for early endometrial cancer is becoming method of choice. Despite prospective data availability there is lack of harmonization in terms of tracers and routes for application.

Methodology Prospective multicentric observational CEEGOG study (NCTO4665544) analyzed SNB using two concurrent tracers administered intracervically in different ways (ICG and radioactive tracer-Tc) within the same patient. The protocol demanded first to detect the SLN using gamma probe (before turning on infrared light), followed by ICG detection. Pelvic±paraaortic lymphadenectomy (LND) followed. The unilateral detection rate (per hemipelvis), the bilateral detection rate (per patient), sensitivity to reflect status of nodes and consistency in SLN detection were calculated.

Results 86 patients (172 hemipelvices) from 6 centers were included. Endometrioid type (77.9%), G2/3 (70.9%) and no LVI (86%) were predominant. The unilateral detection rate was 69.1% for Tc, 84.9% for ICG and 88.4% for both tracers. The bilateral detection rate was 57.0% for Tc, 77.9% for ICG and 82.6% for both. The sensitivity of SLN method to reflect status of nodes was 98.3% for Tc alone, 98.5% for ICG alone and 98.6% for both. In 5 hemipelvices (3%) the Tc detected SLN was different and in different region than ICG detected SLN. All SLN and nodes after LND were in those cases negative. It happened in two different centers that included about 25% of patients each.

Conclusion The result of prospective real-life resembling study showed the superiority of ICG and combination of tracers to Tc alone in unilateral and bilateral detection rate. When SLN was detected, the sensitivity to reflect status of nodes was similar between the tracers and their combination. The discrepancy between SLN traced by one or another tracer within the same patient in 3% of hemipelvices needs clarification of clinical relevance in times of precision medicine development.

Disclosures No disclosures.

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