Can indocyanine green be established as an only sentinel lymph node mapping method in gynecological cancers? Our experience

Aim Indocyanine green (ICG) represents a feasible alternative to the already established methods of sentinel lymph node mapping (SLN) in gynecological cancer. The present study outlines our experience with the method of indocyanine green as the only method of SLN mapping in a minimal invasive approach in women with endometrial and cervical cancer.

Materials A total of 26 patients undergoing laparoscopic surgery from 05.2019 up to 02.2020 for endometrial (N= 13) and cervical (N= 13) cancer in a university hospital. Regarding the SLN mapping, intracervical injection of ICG at the 2,4, 8 and 10 o’clock locations was performed with the patients under general anaesthesia. SLNs were intraoperatively detected, excised and underwent frozen section biopsy.

Methods The overall detection rate, the rate of bilateral SLN detection, the sensitivity and the negative predictive value of SLN detection, the conversion rate to laparotomy and the presence of either intraoperative or postoperative complications were recorded.

Results The overall detection rate of ICG was 100 %. The rate of bilateral SLN detection was 77 % . Positive lymph nodes were found in 11.5 % of the patients with at least 1 positive SLN. All procedures were successfully completed without conversion to open laparotomy, and no complications occurred.

Conclusion In our preliminary experience, ICG showed a high overall detection rate and bilateral SLN detection rate in patients with both endometrial and cervical cancer. This is why we propose ICG as a valid and safe method for SLN mapping with a positive impact in patient’s treatment.

Publication History

Article published online:
07 October 2020