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Risk factors for failure of sentinel lymph node mapping using indocyanine green/near-infrared fluorescent imaging in endometrial cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Side-specific systematic lymphadenectomy is suggested if sentinel lymph node (SLN) mapping failed in early stages endometrial cancer. This study aimed to evaluate the risk factors associated with failed mapping which may lead to modify SLN mapping technique, increase the success of SLN mapping and reduce the necessity of systematic lymphadenectomy.

Methods

Patients with early stage endometrial cancer were included in this study. All patients underwent SLN mapping with indocyanine green/near-infrared compatible surgical platforms. Indocyanine green was injected intracervical. “Bilateral mapping” and “failed bilateral SLN mapping (unilateral or bilateral failed mapping)” groups were compared for demographic, clinical, surgical, and pathological features.

Results

101 cases were analyzed. The overall, unilateral, and bilateral SLN detection rates were 94.1%, 19.8%, and 74.3%, respectively. The failed (unilateral or no mapping) bilateral detection rate was 25.7%. Failed bilateral mapping rates were higher in patients with longer cervical and uterine longitudinal lengths, deep myometrial invasion and larger tumor size without statistical significance. Body mass index and operation type were not related with failed mapping. Increasing number of operations or injection of larger volume of indocyanine green (4 mL vs. 2 mL) did not improve mapping rate significantly.

Conclusion

Cervical indocyanine green injection may overcome the negative effect of obesity on bilateral mapping. Although there was a negative correlation trend between the longitudinal cervical and uterine lengths and bilateral mapping, this possible relation needs to be confirmed in further studies.

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References

  1. 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 125:531–535

    Article  PubMed  Google Scholar 

  2. Kuru O, Topuz S, Sen S et al (2011) Sentinel lymph node biopsy in endometrial cancer: description of the technique and preliminary results. J Turk Ger Gynecol Assoc 12:204–208

    Article  PubMed  PubMed Central  Google Scholar 

  3. Papadia A, Imboden S, Siegenthaler F et al (2016) Laparoscopic indocyanine green sentinel lymph node mapping in endometrial cancer. Ann Surg Oncol 23:2206–2211

    Article  PubMed  PubMed Central  Google Scholar 

  4. Buda A, Bussi B, Di Martino G et al (2016) Sentinel lymph node mapping with near-infrared fluorescent imaging using indocyanine green: a new tool for laparoscopic platform in patients with endometrial and cervical cancer. J Minim Invasive Gynecol 23:265–269

    Article  PubMed  Google Scholar 

  5. Plante M, Touhami O, Trinh XB et al (2015) Sentinel node mapping with indocyanine green and endoscopic near-infrared fluorescence imaging in endometrial cancer. a pilot study and review of the literature. Gynecol Oncol 137:443–447

    Article  PubMed  Google Scholar 

  6. Bodurtha Smith AJ, Fader AN, Tanner EJ (2017) Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. Am J Obstet Gynecol 216:459.e10–476.e10

    Article  Google Scholar 

  7. Darin MC, Gómez-Hidalgo NR, Westin SN et al (2016) Role of indocyanine green in sentinel node mapping in gynecologic cancer: is fluorescence imaging the new standard? J Min Invasive Gynecol 23:186–193

    Article  Google Scholar 

  8. Tanner EJ, Sinno AK, Stone RL et al (2015) Factors associated with successful bilateral sentinel lymph node mapping in endometrial cancer. Gynecol Oncol 138:542–547

    Article  PubMed  Google Scholar 

  9. How JA, O’Farrell P, Amajoud Z et al (2018) Sentinel lymph node mapping in endometrial cancer: a systematic review and meta-analysis. Miner Ginecol 70:194–214

    Google Scholar 

  10. Taskin S, Sukur YE, Altin D et al (2017) Laparoscopic near-infrared fluorescent imaging as an alternative option for sentinel lymph node mapping in endometrial cancer: a prospective study. Int J Surg 47:13–17

    Article  PubMed  Google Scholar 

  11. Rossi EC, Kowalski LD, Scalici J et al (2017) Comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study. Lancet Oncol 18:384–392

    Article  PubMed  Google Scholar 

  12. Hagen B, Valla M, Aune G et al (2016) Indocyanine green fluorescence imaging of lymph nodes during robotic-assisted laparoscopic operation for endometrial cancer. a prospective validation study using a sentinel lymph node surgical algorithm. Gynecol Oncol 143:479–483

    Article  PubMed  Google Scholar 

  13. Papadia A, Zapardiel I, Bussi B et al (2017) Sentinel lymph node mapping in patients with stage I endometrial carcinoma: a focus on bilateral mapping identification by comparing radiotracer Tc99m with blue dye versus indocyanin green fluorescent dye. J Cancer Res Clin Oncol 143:475–480

    Article  CAS  PubMed  Google Scholar 

  14. Xiong L, Gazyakan E, Yang W et al (2014) Indocyanine green fluorescence-guided sentinel node biopsy: a meta-analysis on detection rate and diagnostic performance. Eur J Surg Oncol 40:843–849

    Article  CAS  PubMed  Google Scholar 

  15. Papadia A, Buda A, Gasparri ML et al (2018) The impact of different doses of indocyanine green on the sentinel lymph-node mapping in early stage endometrial cancer. J Cancer Res Clin Oncol 144:2187–2191

    Article  CAS  PubMed  Google Scholar 

  16. Salvo G, Ramirez PT, Levenback CF et al (2017) Sensitivity and negative predictive value for sentinel lymph node biopsy in women with early-stage cervical cancer. Gynecol Oncol 145:96–101

    Article  PubMed  PubMed Central  Google Scholar 

  17. Body N, Grégoire J, Renaud MC et al (2018) Tips and tricks to improve sentinel lymph node mapping with Indocyanin green in endometrial cancer. Gynecol Oncol 150:267–273

    Article  PubMed  Google Scholar 

  18. Casarin J, Multinu F, Pasupathy K et al (2018) Frozen section for detection of lymph nodes after cervical injection with indocyanine green (ICG) for sentinel lymph node technique in endometrial cancer staging. Ann Surg Oncol 25:3692–3698

    Article  PubMed  Google Scholar 

  19. Persson J, Geppert B, Lönnerfors C et al (2017) Description of reproducible anatomically based surgical algorithm for detection of pelvic sentinel lymph nodes in endometrial cancer. Gynecol Oncol 147:120–125

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Ankara University School of Medicine, 06100, Ankara, Turkey

    Salih Taşkın, Duygu Altın, Ali Gökçe & Fırat Ortaç

  2. Department of Obstetrics and Gynecology, Ankara Training and Research Hospital, Ankara, Turkey

    Mustafa Erkan Sarı

  3. Department of Pathology, Ankara University School of Medicine, Ankara, Turkey

    Cevriye Cansız Ersöz, Seher Yüksel & Duygu Kankaya

Authors
  1. Salih Taşkın
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  2. Mustafa Erkan Sarı
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  3. Duygu Altın
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  4. Cevriye Cansız Ersöz
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  5. Ali Gökçe
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  6. Seher Yüksel
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  7. Duygu Kankaya
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  8. Fırat Ortaç
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Contributions

ST: Study design, writing, and approving the final version of the manuscript. ME Sari: Data analysis and writing of the manuscript. DA: Data collection and analysis. CCE: Data collection and writing of the manuscript. AG: Data collection. SY: Data collection. DK: Editing the manuscript. FO: Editing the manuscript.

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Correspondence to Salih Taşkın.

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Taşkın, S., Sarı, M.E., Altın, D. et al. Risk factors for failure of sentinel lymph node mapping using indocyanine green/near-infrared fluorescent imaging in endometrial cancer. Arch Gynecol Obstet 299, 1667–1672 (2019). https://doi.org/10.1007/s00404-019-05137-5

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  • DOI: https://doi.org/10.1007/s00404-019-05137-5

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