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Retrospective validation of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer

Journal of Cancer Research and Clinical Oncology volume 144, pages 1385–1393 (2018)Cite this article

Abstract

Purpose

To evaluate the sensitivity, negative predictive value (NPV) and false-negative (FN) rate of the near infrared (NIR) indocyanine green (ICG) sentinel lymph node (SLN) mapping in patients with poorly differentiated endometrial cancer who have undergone a full pelvic and para-aortic lymphadenectomy after SLN mapping.

Methods

We performed a retrospective analysis of patients with endometrial cancer undergoing a laparoscopic NIR-ICG SLN mapping followed by a systematic pelvic and para-aortic lymphadenectomy. Inclusion criteria were a grade 3 endometrial cancer or a high-risk histology (papillary serous, clear cell carcinoma, carcinosarcoma, and neuroendocrine carcinoma) and a completion pelvic and para-aortic lymphadenectomy to the renal vessels after SLN mapping. Overall and bilateral detection rates, sensitivity, NPV, and FN rates were calculated.

Results

From December 2012 until January 2017, 42 patients fulfilled inclusion criteria. Overall and bilateral detection rates were 100 and 90.5%, respectively. Overall, 23.8% of the patients had lymph node metastases. In one patient, despite negative bilateral pelvic SLNs, a metastatic non-SLN-isolated para-aortic metastasis was detected. This NSLN was clinically suspicious and sent to frozen section analysis during the surgery. FN rate, sensitivity, and NPV were 10, 90, and 97.1%, respectively. For the SLN mapping algorithm, FN rate, sensitivity, and NPV were 0, 100, and 100%, respectively.

Conclusions

Laparoscopic NIR-ICG SLN mapping in high-risk endometrial cancer patients has acceptable sensitivity, FN rate, and NPV.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Effingerstrasse 102, 3010, Bern, Switzerland

    Andrea Papadia, Maria Luisa Gasparri, Anda P. Radan, Chantal A. L. Stämpfli & Michael D. Mueller

  2. Dipartimento Assistenziale Integrato Ostetricia e Ginecologia, Perinatologia e Puericultura, “Sapienza” University of Rome, Rome, Italy

    Maria Luisa Gasparri

  3. Surgical and Medical Department of Translational Medicine, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy

    Maria Luisa Gasparri

  4. Institute of Pathology, University of Bern, Murtenstrasse 31, 3008, Bern, Switzerland

    Tilman T. Rau

Authors
  1. Andrea Papadia
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  2. Maria Luisa Gasparri
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  3. Anda P. Radan
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  4. Chantal A. L. Stämpfli
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  5. Tilman T. Rau
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  6. Michael D. Mueller
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Corresponding author

Correspondence to Andrea Papadia.

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Informed consent was obtained from all individual participants included in the study.

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Papadia, A., Gasparri, M.L., Radan, A.P. et al. Retrospective validation of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer. J Cancer Res Clin Oncol 144, 1385–1393 (2018). https://doi.org/10.1007/s00432-018-2648-y

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  • DOI: https://doi.org/10.1007/s00432-018-2648-y

Keywords

  • Endometrial cancer
  • Sentinel lymph node biopsy
  • Grade 3
  • Uterine papillary serous carcinoma
  • Clear cell carcinoma
  • Carcinosarcomas