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Archives of Gynecology and Obstetrics

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Open Access 01-05-2019 | Endometrial Cancer | Gynecologic Oncology

Sentinel lymph node mapping using indocyanine green in patients with uterine and cervical neoplasms: restrictions of the method

Authors: M. Bedyńska, G. Szewczyk, T. Klepacka, K. Sachadel, T. Maciejewski, D. Szukiewicz, A. Fijałkowska

Published in: Archives of Gynecology and Obstetrics | Issue 5/2019

Abstract

Purpose

To establish the surgical, demographic and histopathological factors associated with inaccurate sentinel lymph nodes (SLNs) identification using indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging in uterine and cervical neoplasms during both open and laparoscopic surgery.

Methods

We reviewed patients with atypical endometrial hyperplasia (AEH), clinical stage I and II cervical cancer or uterine malignancies who underwent primary surgery with SLN mapping between September 2015 and January 2018. An analysis of patients’ demographics, tumor factors and surgical approach was conducted. Bilateral and overall detection rates were calculated and univariate analysis was performed to estimate factors associated with failed SLN mapping.

Results

A total of 32 patients with uterine and cervical neoplasms were included in the study. The overall detection rate of the SLN was 84% and bilateral detection rate was 75%. There were no statistically relevant differences in overall and bilateral SLN detection rates by BMI, surgical approach or age. Regarding endometrial cancer, there were no differences in SLN detection rates when comparing tumor grade, histology nor myometrial invasion. For SLN detection failure, only the presence of metastatic lymph nodes and lack of surgical experience significantly increased the disability to detect SLNs (p = 0.03, p = 0.04, respectively).

Conclusions

SLN mapping technique using NIR fluorescence imaging with ICG appears to be accurate method in most of the patients with cervical or endometrial carcinoma, regardless of demographic characteristics, tumor-related features and surgical approach. Surgeons’ expertise in that field allows obtaining excellent detection rates.

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Title: Sentinel lymph node mapping using indocyanine green in patients with uterine and cervical neoplasms: restrictions of the method
Authors: M. Bedyńska
G. Szewczyk
T. Klepacka
K. Sachadel
T. Maciejewski
D. Szukiewicz
A. Fijałkowska
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keywords: Endometrial Cancer
Cervical Cancer
Endometrial Cancer
Cervical Cancer
Published in: Archives of Gynecology and Obstetrics / Issue 5/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05063-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sentinel lymph node mapping using indocyanine green in patients with uterine and cervical neoplasms: restrictions of the method

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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