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. 2025 Jul 23.
doi: 10.1245/s10434-025-17836-2. Online ahead of print.

The MULTISENT Study: A Multicenter Study on the Detection Rate of Sentinel Lymph Node Mapping in Endometrial Cancer Across Spain

Natalia R Gómez-Hidalgo #  1 , Silvia Cabrera #  2 , Vicente Bebia  3 , Virginia García-Pineda  4 , Pablo Padilla-Iserte  5 , Francesc Fargas Fabregas  6 , Pere Fuste  7 , Paula Alonso  8 , Tomas Gómez Rodriguez  9 , Sergi Fernandez-Gonzalez  10 , Enrique Chacon  11 , Jose Antonio Pérez Alvarez  12 , Reyes Oliver  13 , Antonio Gil-Moreno  3   14
Affiliations

The MULTISENT Study: A Multicenter Study on the Detection Rate of Sentinel Lymph Node Mapping in Endometrial Cancer Across Spain

Natalia R Gómez-Hidalgo et al. Ann Surg Oncol. .

Abstract

Introduction: This study aimed to evaluate the accuracy of sentinel lymph node (SLN) biopsy in endometrial cancer across Spain.

Methods: We conducted a multicenter, retrospective study including patients with stage I-II endometrial cancer (according to International Federation of Gynecology and Obstetrics [FIGO] 2009 criteria, all histologies and grades) who underwent SLN mapping from 2015 to 2022. Indocyanine green (ICG), ICG + technetium-99m (99mTC) and 99mTC with different sites of injections (cervical, uterus, or both) were used. Twenty-nine Spanish centers were enrolled.

Results: Overall, 1221 patients were analyzed. The median number of resected SLNs was 2 (interquartile range 1-3); 526 (43%) patients received ICG, 332 (27.1%) patients received ICG + 99mTC, and 363 (29.7%) patients received 99mTC alone or with blue dye. The cervical injection was used in 1121 (92%) patients, 60 (5%) patients underwent a uterine injection, and 40 (3%) patients received both. The bilateral mapping rates were 324 (61.6%) for the ICG group, 250 (75.3%) for the ICG + 99mTC group, and 173 (47.7%) for the 99mTC group (p < 0.001). The aortic mapping rate was 18 (3.4%) for the ICG group, 38 (11.5 %) for the ICG + 99mTC group, and 25 (6.9%) for the 99mTC group, respectively (p < 0.001). Empty node packets were only diagnosed in 10 (1.6%) patients in the ICG group (p < 0.001). The sensitivity was 77% for the ICG group, 90% for the ICG + 99mTC group, and 97% for the 99mTC-alone group. The false negative rates were 6 (3.2%) for the ICG group, 2 (1.4%) for the CG + 99mTC group, and 1 (0.5%) for the 99mTC-alone group (p < 0.244).

Conclusion: We did not find any differences among tracers in terms of accuracy; otherwise, combining 99mTc and ICG achieved the highest overall and bilateral detection rates.

Keywords: Detection rates; Early stage; Endometrial cancer surgery; ICG; Sentinel lymph node biopsy.

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References

    1. Siegel RL, Miller KD, Sandeep N, Jemal A. Cancer statistics, 2023. CA A Cancer J Clin. 2023;73(1):17–48.
    1. Concin N, Matias-Guiu X, Vergote I, Cibula D, Mirza MR, Marnitz S, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021;31(1):12–39. - PubMed
    1. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology, uterine neoplasms. Available at: https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf .
    1. Diniz TP, Drizlionoks E, Chaves Faloppa C, Nunes Menezes J, Mantoan H, Tirapelli Gonçalves B, et al. Impact of sentinel node mapping in decreasing the risk of lymphocele in endometrial cancer. Ann Surg Oncol. 2021;28(6):3293–9. - PubMed
    1. Persson J, Salehi S, Bollino M, Lönnerfors C, Falconer H, Geppert B. Pelvic Sentinel lymph node detection in High-Risk Endometrial Cancer (SHREC-trial)-the final step towards a paradigm shifts in surgical staging. Eur J Cancer. 2019;1990(116):77–85.

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