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
. 2018 Jul;144(7):1385-1393.
doi: 10.1007/s00432-018-2648-y. Epub 2018 Apr 24.

Retrospective validation of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer

Andrea Papadia  1 , Maria Luisa Gasparri  2   3   4 , Anda P Radan  2 , Chantal A L Stämpfli  2 , Tilman T Rau  5 , Michael D Mueller  2
Affiliations

Retrospective validation of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer

Andrea Papadia et al. J Cancer Res Clin Oncol. 2018 Jul.

Abstract

Purpose: To evaluate the sensitivity, negative predictive value (NPV) and false-negative (FN) rate of the near infrared (NIR) indocyanine green (ICG) sentinel lymph node (SLN) mapping in patients with poorly differentiated endometrial cancer who have undergone a full pelvic and para-aortic lymphadenectomy after SLN mapping.

Methods: We performed a retrospective analysis of patients with endometrial cancer undergoing a laparoscopic NIR-ICG SLN mapping followed by a systematic pelvic and para-aortic lymphadenectomy. Inclusion criteria were a grade 3 endometrial cancer or a high-risk histology (papillary serous, clear cell carcinoma, carcinosarcoma, and neuroendocrine carcinoma) and a completion pelvic and para-aortic lymphadenectomy to the renal vessels after SLN mapping. Overall and bilateral detection rates, sensitivity, NPV, and FN rates were calculated.

Results: From December 2012 until January 2017, 42 patients fulfilled inclusion criteria. Overall and bilateral detection rates were 100 and 90.5%, respectively. Overall, 23.8% of the patients had lymph node metastases. In one patient, despite negative bilateral pelvic SLNs, a metastatic non-SLN-isolated para-aortic metastasis was detected. This NSLN was clinically suspicious and sent to frozen section analysis during the surgery. FN rate, sensitivity, and NPV were 10, 90, and 97.1%, respectively. For the SLN mapping algorithm, FN rate, sensitivity, and NPV were 0, 100, and 100%, respectively.

Conclusions: Laparoscopic NIR-ICG SLN mapping in high-risk endometrial cancer patients has acceptable sensitivity, FN rate, and NPV.

Keywords: Carcinosarcomas; Clear cell carcinoma; Endometrial cancer; Grade 3; Sentinel lymph node biopsy; Uterine papillary serous carcinoma.

PubMed Disclaimer

Conflict of interest statement

None of the authors have any conflict of interest.

Figures

Fig. 1
Fig. 1
Extent of para-aortic lymphadenectomy in patients undergoing full surgical staging included in the study
Fig. 2
Fig. 2
Study cohort
See this image and copyright information in PMC

References

    1. ASTEC Study Group, Kitchener H, Swart AM et al (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 373:125–136 - DOI - PMC - PubMed
    1. Ballester M, Dubernard G, Lécuru F et al (2011) Detection rate and diagnostic accuracy of sentinel-node biopsy in early stage endometrial cancer: a prospective multicentre study (SENTI-ENDO). Lancet Oncol 12:469–476 - DOI - PubMed
    1. Barlin JN, Khoury-Collado F, Kim CH et al (2012) The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: beyond removal of blue nodes. Gynecol Oncol 125:531–535 - DOI - PubMed
    1. Benedetti Panici P, Basile S, Maneschi F et al (2008) Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst 100:1707–1716 - DOI - PubMed
    1. Buda A, Papadia A, Zapardiel I, Vizza E, Ghezzi F, De Ponti E, Lissoni AA, Imboden S, Diestro MD, Verri D, Gasparri ML, Bussi B, Di Martino G, de la Noval BD, Mueller M, Crivellaro C (2016) From conventional radiotracer Tc-99(m) with blue dye to indocyanine green fluorescence: a comparison of methods towards optimization of sentinel lymph node mapping in early stage cervical cancer for a laparoscopic approach. Ann Surg Oncol 23:2959–2965 - DOI - PubMed

Publication types

MeSH terms

Substances