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Journal of Cancer Research and Clinical Oncology
Published in: Journal of Cancer Research and Clinical Oncology 10/2017

01-10-2017 | Review – Clinical Oncology

Sentinel lymph node mapping in endometrial cancer: comparison of fluorescence dye with traditional radiocolloid and blue

Authors: Andrea Papadia, Maria Luisa Gasparri, Alessandro Buda, Michael D. Mueller

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2017

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Abstract

Sentinel lymph node (SLN) mapping in endometrial cancer (EMCA) is rapidly gaining acceptance in the clinical community. As compared to a full lymphadenectomy in every patient, to a selective lymphadenectomy after frozen section of uterus in selected patients with intrauterine risk factors or to a strategy in which a lymphadenectomy is always omitted, SLN mapping seems to be a reasonable and oncologically safe middle ground. Various protocols can be used when applying an SLN mapping. In this manuscript we review the characteristics, toxicity and clinical impact of technetium-99m radiocolloid (Tc-99m), of the blue dyes (methylene blue, isosulfan blue and patent blue) and of indocyanine green (ICG). ICG has an excellent toxicity profile, has higher overall and bilateral detection rates as compared to blue dyes and higher bilateral detection rates as compared to a combination of Tc-99m and blue dye. The detrimental effect of BMI on the detection rates is attenuated when ICG is used as a tracer. The ease of use of the ICG SLN mapping is perceived by the patients as a better quality of care delivered. Whenever possible, ICG should be favored over the other tracers for SLN mapping in EMCA patients.
Literature
Albo D, Wayne JD, Hunt KK et al (2001) Anaphylactic reactions to isosulfan blue dye during sentinel lymph node biopsy for breast cancer. Am J Surg 182:393–398CrossRefPubMed
ASTEC study group; Kitchener H, Swart AM et al (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomized study. Lancet 373:125–36
Ballard-Barbash R, Swanson CA (1996) Body weight: estimation of risk for breast and endometrial cancers. Am J Clin Nutr 63:437S–441SPubMed
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 12:469–476CrossRefPubMed
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 125:531–535CrossRefPubMed
Bellati F, Papadia A, Gasparri ML et al (2017) Tertiary cytoreduction for recurrent endometrial cancer. Eur J Gynaecol Oncol 38:132–134
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 100:1707–1716CrossRefPubMed
Blessing WD, Stolier AJ, Teng SC et al (2002) A comparison of methylene blue and lymphazurin in breast cancer sentinel node mapping. Am J Surg 184:341–345CrossRefPubMed
Bodurtha Smith AJ, Fader AN, Tanner EJ (2017) Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. An J Obstet Gynecol. 216:459–476CrossRef
Bogani G, Dowdy SC, Cliby WA et al (2014) Role of pelvic and para-aortic lymphadenectomy in endometrial cancer: current evidence. J Obstet Gynaecol Res 40:301–311CrossRefPubMedPubMedCentral
Brar H, Hogen L, Covens A (2017) Cost-effectiveness of sentinel node biopsy and pathological ultrastaging in patients with early-stage cervical cancer. Cancer 123:1751–1759CrossRefPubMed
Buda A, Elisei F, Palazzi S et al (2016a) Quality of care for cervical and endometrial cancer patients: the impact of different techniques of sentinel lymph node mapping on patient satisfaction. Ann Surg Oncol 23:2975–2981CrossRefPubMed
Buda A, Crivellaro C, Elisei F et al (2016b) Impact of indocyanine green for sentinel lymph node mapping in early stage endometrial and cervical cancer: comparison with conventional radiotracer (99m)Tc and/or blue dye. Ann Surg Oncol 23:2183–2191CrossRefPubMed
Buda A, Papadia A, Zapardiel I et al (2016c) 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 23:2959–2965CrossRefPubMed
Chagpar AB, Martin RC, Scoggins CR et al (2005) Factors predicting failure to identify a sentinel lymph node in breast cancer. Surgery 138:56–63CrossRefPubMed
Cimmino VM, Brown AC, Szocik JF et al (2001) Allergic reactions to isosulfan blue during sentinel node biopsy—a common event. Surgery 130:439–442CrossRefPubMed
Cohn DE, Huh WK, Fowler JM et al (2007) Cost-effectiveness analysis of strategies for the surgical management of grade 1 endometrial adenocarcinoma. Obstet Gynecol 109:1388–1395CrossRefPubMed
Colombo N, Creutzberg C, Amant F et al (2016) ESMOESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 27:16–41
Cordova MA, Hladik WB, Rhodes BA (1984) Validation and characterization of adverse reactions to radiopharmaceuticals. Noninvasive Med Imag 1:17–24
Derossis AM, Fey JV, Cody HS, Borgen PI (2003) Obesity influences outcome of sentinel lymph node biopsy in early-stage breast cancer. J Am Coll Surg 197:896–901CrossRefPubMed
Di Martino G, Crivellaro C, De Ponti E et al (2017) Indocyanine green versus radiotracer ± blue dye for sentinel lymph node mapping in >Stage IB1 cervical cancer (>2 cm). J Minim Invasive Gynecol. doi:10.​1016/​j.​jmig.​2017.​05.​011 (Epub ahead of print)
Ditto A, Martinelli F, Bogani G et al (2015) Sentinel node mapping using hysteroscopic injection of indocyanine green and laparoscopic near-infrared fluorescence imaging in endometrial cancer staging. J Minim Invas Gynecol 22:132–133CrossRef
Elisei F, Crivellaro C, Giuliani D et al (2017) Sentinel-node mapping in endometrial cancer patients: comparing SPECT/CT, gamma-probe and dye. Ann Nucl Med 31:93–99CrossRefPubMed
Eriksson AG, Montovano M, Beavis A et al (2016) Impact of obesity on sentinel lymph node mapping in patients with newly diagnosed uterine cancer undergoing robotic surgery. Ann Surg Oncol 23:2522–2528CrossRefPubMed
Eriksson AG, Beavis A, Soslow RA et al (2017) A comparison of the detection of sentinel lymph nodes using indocyanine green and near-infrared fluorescence imaging versus blue dye during robotic surgery in uterine cancer. Int J Gynecol Cancer. 27:743–747CrossRefPubMed
Friedlaender P. (1888) Fortschitte der Theerfabenfabrikation und verwandter Industriezweige, vol 1. Julius Springer, Berlin, pp 247–249
Gasparri ML, Panici PB, Papadia A (2015) Primary chemotherapy versus primary surgery for ovarian cancer. Lancet 386:2142–2143CrossRefPubMed
Gasparri ML, Grandi G, Bolla D et al (2016) Hepatic resection during cytoreductive surgery for primary or recurrent epithelial ovarian cancer. J Cancer Res Clin Oncol 142:1509–1520CrossRefPubMed
Golshan M, Nakhlis F (2006) Can methylene blue only be used in sentinel lymph node biopsy for breast cancer? Breast J 12:428–430CrossRefPubMed
Hirsch JI, Tisnado J, Cho SR, Beachley MC (1982) Use of isosulfan blue for identification of lymphatic vessels: experimental and clinical evaluation. AJR Am J Roentgenol 139:1061–1064CrossRefPubMed
Holloway RW, Bravo RA, Rakowski JA et al (2012) Detection of sentinel lymph nodes in patients with endometrial cancer undergoing robotic-assisted staging: a comparison of colorimetric and fluorescence imaging. Gynecol Oncol 126:25–29CrossRefPubMed
Holloway RW, Abu-Rustum NR, Backes FJ et al (2017a) Sentinel lymph node mapping and staging in endometrial cancer: a society of gynecologic oncology literature review with consensus recommendations. Gynecol Oncol. doi:10.​1016/​j.​ygyno.​2017.​05.​027 (Epub ahead of print)
Hope-Ross M, Yannuzzi LA, Gragoudas ES et al (1994) Adverse reactions due to indocyanine green. Ophthalmology 101:529–533CrossRefPubMed
How J, Gotlieb WH, Press JZ et al (2015) Comparing indocyanine green, technetium, and blue dye for sentinel lymph node mapping in endometrial cancer. Gynecol Oncol 137:436–442CrossRefPubMed
Imboden S, Papadia A, Nauwerk M et al (2015) A comparison of radiocolloid and indocyanine green fluorescence imaging, sentinel lymph node mapping in patients with cervical cancer undergoing laparoscopic surgery. Ann Surg Oncol 22:4198–4203CrossRefPubMedPubMedCentral
Johann S, Klaeser B, Krause T, Mueller MD (2008) Comparison of outcome and recurrence-free survival after sentinel lymph node biopsy and lymphadenectomy in vulvar cancer. Gynecol Oncol 110:324–328CrossRefPubMed
Khoury-Collado F, Glaser GE, Zivanovic O et al (2009) Improving sentinel lymph node detection rates in endometrial cancer: how many cases are needed? Gynecol Oncol 115:453–455CrossRefPubMed
Kieckbusch H, Coldewey SM, Hollenhorst J et al (2008) Patent blue sentinel node mapping in cervical cancer patients may lead to decreased pulse oximeter readings and positive methaemoglobin results. Eur J Anaesthesiol 25:365–368CrossRefPubMed
Krohne TU, Allam JP, Novak N, Holz FG (2016) “Iodine allergy”: a medical myth with risks for the ophthalmological patient. Ophthalmologe 113:1023–1028CrossRefPubMed
Lambrou NC, Gómez-Marín O, Mirhashemi R et al (2004) Optimal surgical cytoreduction in patients with Stage III and Stage IV endometrial carcinoma: a study of morbidity and survival. Gynecol Oncol 93:653–658CrossRefPubMed
Laufer J, Scasso S, Papadia A et al (2013) Association between tumor diameter and lymphovascular space invasion among women with early-stage endometrial cancer. Int J Gynaecol Obstet 123:142–145CrossRefPubMed
Leong SP, Donegan E, Heffernon W et al (2007) Adverse reactions to isosulfan blue during selective sentinel lymph node dissection in melanoma. Ann Surg Oncol 7:361–366CrossRef
Lin H, Ding Z, Kota VG et al (2017) Sentinel lymph node mapping in endometrial cancer: a systematic review and meta-analysis. Oncotarget. doi:10.​18632/​oncotarget.​1662 (Epub ahead of print) Review
Lyman GH, Giuliano AE, Somerfield MR et al (2005) American society of clinical oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 23:7703–7720CrossRefPubMed
Martinelli F, Ditto A, Boga et al (2017) Laparoscopic sentinel node mapping in endometrial cancer after hysteroscopic injection of indocyanine green. J Minim Invasive Gynecol 24:89–93CrossRefPubMed
Masannat Y, Shenoy H, Speirs V et al (2006) Properties and characteristics of the dyes injected to assist axillary sentinel node localization in breast surgery. Eur J Surg Oncol 32:381–384CrossRefPubMed
Montgomery LL, Thorne AC, Van Zee KJ et al (2002) Isosulfan blue dye reactions during sentinel lymph node mapping for breast cancer. Anesth Analg 95:385–388PubMed
Morotti M, Menada MV, Moioli M et al (2012) Frozen section pathology at time of hysterectomy accurately predicts endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia. Gynecol Oncol 125:536–540CrossRefPubMed
Morotti M, Menada MV, Boccardo F et al (2013) Lymphedema microsurgical preventive healing approach for primary prevention of lower limb lymphedema after inguinofemoral lymphadenectomy for vulvar cancer. Int J Gynecol Cancer 23:769–774CrossRefPubMed
Morton DL, Thompson JF, Cochran AJ et al (2006) Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 355:1307–1317CrossRefPubMed
Papadia A, Morotti M (2013) Diaphragmatic surgery during cytoreduction for primary or recurrent epithelial ovarian cancer: a review of the literature. Arch Gynecol Obstet 287:733–741CrossRefPubMed
Papadia A, Remorgida V, Salom EM, Ragni N (2004) Laparoscopic pelvic and paraaortic lymphadenectomy in gynecologic oncology. J Am Assoc Gynecol Laparosc 11:297–306CrossRefPubMed
Papadia A, Ragni N, Salom EM (2006) The impact of obesity on surgery in gynecological oncology: a review. Int J Gynecol Cancer. 16:944–952CrossRefPubMed
Papadia A, Azioni G, Brusaca B et al (2009) Frozen section underestimates the need for surgical staging in endometrial cancer patients. Int J Gynecol Cancer 19:1570–1573CrossRefPubMed
Papadia A, Bellati F, Ditto A et al (2015) Surgical treatment of recurrent endometrial cancer: time for a paradigm shift. Ann Surg Oncol 22:4204–4210CrossRefPubMed
Papadia A, Imboden S, Gasparri ML et al (2016a) Endometrial and cervical cancer patients with multiple sentinel lymph nodes at laparoscopic ICG mapping: how many are enough? J Cancer Res Clin Oncol 142:1831–1836CrossRefPubMed
Papadia A, Imboden S, Siegenthaler F et al (2016b) Laparoscopic indocyanine green sentinel lymph node mapping in endometrial cancer. Ann Surg Oncol 23:2206–2211CrossRefPubMedPubMedCentral
Papadia A, Mohr S, Imboden S et al (2016c) Laparoscopic indocyanine green sentinel lymph node mapping in pregnant cervical cancer patients. J Minim Invasive Gynecol 1(23):270–273CrossRef
Papadia A, Gasparri ML, Mueller MD (2017a) Is it time to consider the sentinel lymph node mapping the new standard in endometrial cancer? Transl Cancer Res. Accepted for publication. doi:10.​21037/​tcr.​2017.​05.​10
Papadia A, Gasparri ML, Siegenthaler F et al (2017b) FIGO stage IIIC endometrial cancer identification among patients with complex atypical hyperplasia, grade 1 and 2 endometrioid endometrial cancer: laparoscopic indocyanine green sentinel lymph node mapping versus frozen section of the uterus, why get around the problem? J Cancer Res Clin Oncol 143:491–497CrossRefPubMed
Papadia A, Zapardiel I, Bussi B et al (2017c) Sentinel lymph node mapping in patients with stage I endometrial carcinoma: a focus on bilateral mapping identification by comparing radiotracer Tc99 <sup> m </sup> with blue dye versus indocyanine green fluorescent dye. J Cancer Res Clin Oncol 143:475–480CrossRefPubMed
Papadia A, Nirgianakis K, Gasparri ML et al (2017d) PET/CT guided surgical excision of small abdominal wall metastases in morbidly obese endometrial cancer patients. Minerva Ginecol 69:206–207PubMed
Pinero A, Illana J, Garcia-Palenciano C et al (2004) Effect on oximetry of dyes used for sentinel lymph node biopsy. Arch Surg 139:1204–1207CrossRefPubMed
Richards P, Tucker WD, Srivastava SC (1982) Technetium-99m: an historical perspective. Int J Appl Radiat Isotopes 33:793–799CrossRef
Rossi EC, Kowalski LD, Scalici J et al (2017) A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study. Lancet Oncol 18:384–392CrossRefPubMed
Ruscito I, Gasparri ML, Braicu EI et al (2016) Sentinel node mapping in cervical and endometrial cancer: indocyanine green versus other conventional dyes—a metaanalysis. Ann Surg Oncol 23:3749–3756CrossRefPubMed
Sala P, Morotti M, Menada MV et al (2014) Intraoperative frozen section risk assessment accurately tailors the surgical staging in patients affected by early-stage endometrial cancer: the application of 2 different risk algorithms. Int J Gynecol Cancer 24:1021–1026CrossRefPubMed
Segrè E, Seaborg GT (1938) Nuclear isomerism in element 43. Phys Rev 54:772CrossRef
Sharma C, Deutsch I, Lewin SN et al (2011) Lymphadenectomy influences the utilization of adjuvant radiation treatment for endometrial cancer. Am J Obstet Gynecol 205:e1–e9CrossRef
Simpkins F, Papadia A, Kunos C et al (2013) Patterns of recurrence in stage I endometrioid endometrial adenocarcinoma with lymphovascular space invasion. Int J Gynecol Cancer 23:98–104CrossRefPubMed
Sinno AK, Fader AN, Roche KL et al (2014) A comparison of colorimetric versus fluorometric sentinel lymph node mapping during robotic surgery for endometrial cancer. Gynecol Oncol 134:281–286CrossRefPubMed
Sinno AK, Peijnenburg E, Fader AN et al (2016) Reducing overtreatment: a comparison of lymph node assessment strategies for endometrial cancer. Gynecol Oncol 143:281–286CrossRefPubMed
Soran A, Falk J, Bonaventura M et al (2007) Does failure to visualize a sentinel node on preoperative lymphoscintigraphy predict a greater likelihood of axillary lymph node positivity? J Am Coll Surg 205:66–71CrossRefPubMed
Takahashi N, Nimura H, Fujita T et al (2017) The evident fluorescent signal helps making the identification of the SLN easier. Laparoscopic sentinel node navigation surgery for early gastric cancer: a prospective multicenter trial. Langenbecks Arch Surg 402:27–32CrossRefPubMed
Tanner EJ, Sinno AK, Stone RL et al (2015) Factors associated with successful bilateral sentinel lymph node mapping in endometrial cancer. Gynecol Oncol 138:542–547CrossRefPubMed
Valenzano Menada M, Papadia A, Lorenzi P et al (2003) Breast cancer metastatic to the vulva after local recurrence occurring on a rectus abdominis myocutaneous flap: a case report and review of the literature. Eur J Gynaecol Oncol 24:577–579PubMed
Van der Zee AG, Oonk MH, De Hullu JA et al (2008) Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol 26:884–889CrossRefPubMed
Varghese P, Abdel-Rahman AT, Akberali S et al (2008) Methylene blue dye—a safe and effective alternative for sentinel lymph node localization. Breast J 14:61–67CrossRefPubMed
Veronesi U, Paganelli G, Viale G (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349:546–553CrossRefPubMed
Vieira SC, Sousa RB, Tavares MB et al (2008) Changes in pulse oximetry after patent blue dye injection into the uterine cervix. Ann Surg Oncol 15:2862–2866CrossRefPubMed
Walker JL, Piedmonte MR, Spirtos NM et al (2009) Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: gynecologic Oncology Group Study LAP2. J Clin Oncol 27:5331–5336CrossRefPubMedPubMedCentral
Wright JD, Cham S, Chen L et al (2017) Utilization of sentinel lymph node biopsy for uterine cancer. Am J Obstet Gynecol. 216:594.e1–594.e13
Metadata
Title
Sentinel lymph node mapping in endometrial cancer: comparison of fluorescence dye with traditional radiocolloid and blue
Authors
Andrea Papadia
Maria Luisa Gasparri
Alessandro Buda
Michael D. Mueller
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 10/2017
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-017-2501-8

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Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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