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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 indocyanine green fluorescent dye

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

The aim of this study was to compare technetium radiocolloid (Tc99m) + blue dye (BD) versus Indocyanine green (ICG) fluorescent dye in terms of the overall detection rate and bilateral sentinel lymph node (SLN) mapping in patients with endometrial carcinoma.

Methods

Patients from five European centers with apparently confined clinical stage I endometrial cancer were reviewed. A comparison was made between women who received SLN mapping with pelvic and/or aortic lymphadenectomy (LND), and women who underwent SLN algorithm (SA), was also performed between the two groups.

Results

Three hundred and forty-two (342) women were involved (147 in the Tc99m + BD group and 195 in the ICG group). The overall detection rate of SLN biopsy was 97.3% (143/147) for women in the Tc99m + BD group and 96.9% (189/195) for women in the ICG group (p = 0.547). The bilateral mapping rate for ICG was 84.1%—significantly higher with respect to the 73.5% obtained with Tc99m + BD (p = 0.007). No differences in overall sensitivity (OS) and overall false negative rate (FNR) were seen between LND and SA (p value = 0.311), whereas the negative predictive value (NPV) was in favor of SA group (p value = 0.030).

Conclusions

In this study, fluorescent mapping using ICG resulted equivalent to the standard combined radiocolloid and BD, but real-time SLN mapping achieves a higher bilateral detection rate. The added value that this fast emerging technology promises to give certainly warrants future studies to further consolidate the advantages there are over the standard technique.

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Acknowledgements

We thank Stefano Uccella, MD, from Varese Hospital for his valuable contribution in the data analysis and Patricia Ann Sawchuk for her friendship and valid support in the final revision of the article.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Berne, Berne, Switzerland

    Andrea Papadia, Sara Imboden, Maria Luisa Gasparri & Michael Mueller

  2. Gynaecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain

    Ignacio Zapardiel, Begoña Diaz de la Noval & Javier De Santiago

  3. Unit of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy

    Beatrice Bussi, Giampaolo Di Martino, Francesca Vecchione, Federica Dell’Orto & Alessandro Buda

  4. Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy

    Fabio Ghezzi

  5. Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery International School of Surgical Anatomy Sacred Heart Hospital, Negrar, Verona, Italy

    Marcello Ceccaroni

  6. Department of Medical Physics, San Gerardo Hospital, Monza, Italy

    Elena De Ponti

  7. Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy

    Federica Elisei

Authors
  1. Andrea Papadia
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  2. Ignacio Zapardiel
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  3. Beatrice Bussi
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  6. Elena De Ponti
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  7. Federica Elisei
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  8. Sara Imboden
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  9. Begoña Diaz de la Noval
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  10. Maria Luisa Gasparri
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  11. Giampaolo Di Martino
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  12. Javier De Santiago
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  13. Michael Mueller
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  14. Francesca Vecchione
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  15. Federica Dell’Orto
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  16. Alessandro Buda
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Corresponding author

Correspondence to Alessandro Buda.

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Papadia, A., Zapardiel, I., Bussi, B. et al. 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 indocyanine green fluorescent dye. J Cancer Res Clin Oncol 143, 475–480 (2017). https://doi.org/10.1007/s00432-016-2297-y

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  • DOI: https://doi.org/10.1007/s00432-016-2297-y

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