A new approach to surgical staging in endometrial cancer. Experience of the N.N. Petrov National Medical Research Center of Oncology
Abstract
The aim of the study was to evaluate the effectiveness of the method for detecting sentinel lymph nodes (SLN) in patients with endometrial cancer (EC).
Results. In the present study, 220 SLNs were detected in 100 patients with endometrial cancer using ICG detection. SLN stained bilaterally in 90/100 (90%) patients. In 9/100 (9%), staining was noted on only one side. Only in one case, SLN was not detected. The sensitivity of the method was 100%, the specificity was 93%, the accuracy of the method was 93%.
Conclusion. The use of a fluorescent SLN detection method using ICG in EC contributes to a more accurate assessment of the state of regional lymphatic collectors, correct determination of the disease stage, and individualization of the volume of surgical treatment.
Keywords:uterine body cancer; sentinel lymph node; ICG; fluorescence
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ibragimov Z.N., Gorodnova T.V., Berlev I.V. A new approach to surgical staging in endometrial cancer. Experience of the N.N. Petrov National Medical Research Center of Oncology. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2023; 11 (4): 21–6. DOI: https://doi.org/10.33029/2303-9698-2023-11-4-21-26 (in Russian)
References
1. Berlev I.V., Ul’rikh E.A., Ibragimov Z.N., Guseynov K.D.., Gorodnova T.V., Novikov S.N., et al. Possibilities of detection of sentinel lymph nodes in endometrial cancer by radioisotope and fluorescent (ICG) methods. Voprosy oncologii [Problems in Oncology]. 2017; 63 (2): 304–8. (in Russian)
2. Shepherd E.S., Lowe D.A. Targeted selective trachelo-colpectomy for preservation of fertility in a young woman with vaginal clear cell carcinoma. J Obstet Gynaecol. 2010; 30 (4): 420–1.
3. Vidal F., et al. Evaluation of the sentinel lymph node algorithm with blue dye labeling for early- stage endometrial cancer in a multicentric setting. Int J Gynecol Cancer. 2013; 23: 1237–43.
4. Kadkhodayan S., et al. Lymphatic mapping and sentinel node biopsy in endometrial cancer a feasibility study using cervical injection of radiotracer and blue dye. Nucl Med Rev Cent East Eur. 2014; 17: 55–8.
5. Morton D.L., et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992; 127: 392–9.
6. Krag D.N., et al. Technical outcomes of sentinel lymph-node resection and conventional axillary - lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007; 8: 881–8.
7. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Endometrial Cancer [Electronic resource]. URL: https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf (date of access August 10, 2018).
8. Frumovitz M., et al. Near-infrared fluorescence for detection of sentinel lymph nodes in women with cervical and uterine cancers (FILM): a randomised, phase 3, multicentre, non-inferiority trial. Lancet Oncol. 2018; 19: 1394–403.
9. Quevedo C., et al. Personalized sentinel node mapping in endometrial cancer by the indocyanine green implementation as single tracer: a case control study. J Pers Med. 2023; 13: 170–7.
10. Burg L.C., et al. The added value of SLN mapping with indocyanine green in low- and intermediate-risk endometrial cancer management: a systematic review and meta-analysis. J Gynecol Oncol. 2022; 33: 66–75.