Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;23(7):2206-11.
doi: 10.1245/s10434-016-5090-x. Epub 2016 Jan 20.

Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Endometrial Cancer

Andrea Papadia  1 , Sara Imboden  2 , Franziska Siegenthaler  2 , Maria Luisa Gasparri  2   3 , Stefan Mohr  2 , Susanne Lanz  2 , Michael D Mueller  2
Affiliations

Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Endometrial Cancer

Andrea Papadia et al. Ann Surg Oncol. 2016 Jul.

Abstract

Background: In endometrial cancer (EMCA), indocyanine green (ICG) sentinel lymph node (SLN) mapping has been reported, mainly in conjunction with robotic surgery.

Objective: We aimed to evaluate detection rates, sensitivity, and false negative (FN) rate of laparoscopic ICG SLN mapping in EMCA, and to evaluate differences in surgical outcomes between patients subjected to SLN biopsy only versus lymphadenectomy.

Methods: A retrospective analysis of EMCA patients undergoing ICG SLN mapping ± pelvic (PLND) and/or para-aortic lymphadenectomy (PALND) was performed. Detection rates were calculated for the entire cohort. Sensitivity and FN rates were calculated for patients undergoing lymphadenectomy after SLN mapping, and surgical outcome was compared among patients undergoing SLN mapping only versus lymphadenectomy.

Results: Of 75 patients, 33 underwent SLN mapping and 42 underwent SLN mapping followed by PLND/PALND. Overall and bilateral detection rates were 96 % (72/75) and 88 % (66/75), respectively, and the median number of removed SLNs, pelvic non-SLNs (NSLN) and para-aortic NSLNs was 3, 27, and 19, respectively. With a FN rate of 8.3 %, only one patient had bilateral FN SLNs and a metastatic para-aortal NSLN. Estimated blood loss (EBL) and operative (OR) time were significantly lower in patients undergoing SLN mapping only. No differences in complication rates between patients undergoing SLN mapping only and patients undergoing lymphadenectomy were recorded.

Conclusions: Laparoscopic ICG SLN mapping has excellent overall and bilateral detection rates and a low FN rate. Compared with lymphadenectomy, SLN biopsy is associated with significantly lower EBL and shorter OR time.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Anatomic distribution of sentinel lymph node. Obturator fossa 55 %, external iliac artery 32 %, common iliac artery 8 %, aortic bifurcation 4 %, para-aortic area 1 %
See this image and copyright information in PMC

References

    1. Creasman WT. FIGO stages: 1988 revisions. Gynecol Oncol. 1989;35(7):125–127.
    1. Kumar S, Medeiros F, Dowdy SC, et al. A prospective assessment of the reliability of frozen section to direct intraoperative decision making in endometrial cancer. Gynecol Oncol. 2012;127:525–531. doi: 10.1016/j.ygyno.2012.08.024. - DOI - PubMed
    1. Sala P, Morotti M, Menada MV, et al. Intraoperative frozen section risk assessment accurately tailors the surgical staging in patients affected by early-stage endometrial cancer: the application of 2 different risk algorithms. Int J Gynecol Cancer. 2014;24:1021–1026. doi: 10.1097/IGC.0000000000000145. - DOI - PubMed
    1. Papadia A, Azioni G, Brusacà B, et al. Frozen section underestimates the need for surgical staging in endometrial cancer patients. Int J Gynecol Cancer. 2009;19(9):1570–1573. doi: 10.1111/IGC.0b013e3181bff64b. - DOI - PubMed
    1. Morotti M, Menada MV, Moioli M, et al. Frozen section pathology at time of hysterectomy accurately predicts endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia. Gynecol Oncol. 2012;125(3):536–540. doi: 10.1016/j.ygyno.2012.02.011. - DOI - PubMed

MeSH terms