Laparoscopic near-infrared fluorescent imaging as an alternative option for sentinel lymph node mapping in endometrial cancer: A prospective study


TAŞKIN S., ŞÜKÜR Y. E., Altın D., Ersöz C. C., TURGAY B., ENNELİ D., ...More

International Journal of Surgery, vol.47, pp.13-17, 2017 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 47
  • Publication Date: 2017
  • Doi Number: 10.1016/j.ijsu.2017.09.015
  • Journal Name: International Journal of Surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.13-17
  • Keywords: Endometrial cancer, Indocyanine green, Laparoscopy, Sentinel lymph node
  • Ankara Yıldırım Beyazıt University Affiliated: No

Abstract

Background To evaluate feasibility of sentinel lymph node (SLN) mapping by using near-infrared fluorescent imaging and indocyanine green (NIR/ICG) integrated laparoscopic system in clinically uterine-confined endometrial cancer. Materials and methods Patients with clinically early-stage endometrial cancer were included in this prospective study. ICG was injected to the uterine cervix and NIR/ICG integrated laparoscopic system (Spies Full HD D-Light P ICG technology, Karl Storz, Tuttlingen, Germany) was used during the operations. SLN and/or suspicious lymph nodes were resected. Side specific lymphadenectomy was performed when mapping was unsuccessful. Systematic lymphadenectomy was completed following SLN algorithm steps. Results Seventy-one eligible patients were analyzed. The overall, unilateral and bilateral SLN detection rates were 95.7%, 18.3%, 77.4%, respectively. There were 8 (11.2%) patients with lymph node metastasis. One of them was isolated para-aortic node metastasis. Negative predictive value, sensitivity and false negative rate for detecting lymphatic spread were 98.4%, 87.5% and 1.5%, respectively. Conclusion Sentinel lymph node mapping can easily be performed with high accuracy by using NIR/ICG integrated conventional laparoscopic system in endometrial cancer and almost all lymphatic spread can be detected.