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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2016

Open Access 01-07-2016 | Gynecologic Oncology

Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Endometrial Cancer

Authors: Andrea Papadia, MD, PhD, Sara Imboden, MD, Franziska Siegenthaler, MD, Maria Luisa Gasparri, MD, Stefan Mohr, MD, Susanne Lanz, MD, Michael D. Mueller, MD

Published in: Annals of Surgical Oncology | Issue 7/2016

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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.
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Metadata
Title
Laparoscopic Indocyanine Green Sentinel Lymph Node Mapping in Endometrial Cancer
Authors
Andrea Papadia, MD, PhD
Sara Imboden, MD
Franziska Siegenthaler, MD
Maria Luisa Gasparri, MD
Stefan Mohr, MD
Susanne Lanz, MD
Michael D. Mueller, MD
Publication date
01-07-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 7/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5090-x

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