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Multicenter Study
. 2023 Feb 16;20(4):3476.
doi: 10.3390/ijerph20043476.

Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer

Benito Chiofalo  1 , Antonio Simone Laganà  2 , Fabio Ghezzi  3 , Camilla Certelli  1 , Jvan Casarin  3 , Valentina Bruno  1 , Isabella Sperduti  4 , Vito Chiantera  2 , Panagiotis Peitsidis  5 , Enrico Vizza  1
Affiliations
Multicenter Study

Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer

Benito Chiofalo et al. Int J Environ Res Public Health. .

Abstract

Background: The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC).

Methods: This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study.

Results: The two groups were homogeneous for age (p = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages (p = 0.41 for EC; p = 0.17 for CC), median estimated blood loss (p = 0.76), median operative time (p = 0.59), and perioperative complications (p = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher (p = 0.005) in the ICG group (n = 18) compared with controls (n = 16).

Conclusions: The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.

Keywords: cervical cancer; endometrial cancer; gynecologic oncology; indocyanine green; laparoscopy; minimally invasive surgery; pelvic lymphadenectomy; robotic surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Median number of harvest lymph nodes in patients who underwent either ICG guided systematic pelvic lymphadenectomy (ICG-LND) or standard systematic pelvic lymphadenectomy without ICG (Conventional-LND): (a) overall (endometrial and cervical cancer); (b) endometrial cancer; (c) cervical cancer.
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