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The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study

Background and objectives. Systematic pelvic lymphadenectomy (LND) is an essential part of lymph-node status evaluation in endometrial cancer (EC) patients to tailor the adjuvant treatment. However, it is associated with the post-operative lymphatic complications and does not improve the outcomes of...

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Autores principales: Gedgaudaite, Migle, Sukovas, Arturas, Paskauskas, Saulius, Bartusevicius, Arnoldas, Atstupenaite, Vaida, Svedas, Eimantas, Celiesiute, Joana, Cizauskas, Arvydas, Vaitkiene, Daiva, Gaurilcikas, Adrius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227427/
https://www.ncbi.nlm.nih.gov/pubmed/35743975
http://dx.doi.org/10.3390/medicina58060712
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author Gedgaudaite, Migle
Sukovas, Arturas
Paskauskas, Saulius
Bartusevicius, Arnoldas
Atstupenaite, Vaida
Svedas, Eimantas
Celiesiute, Joana
Cizauskas, Arvydas
Vaitkiene, Daiva
Gaurilcikas, Adrius
author_facet Gedgaudaite, Migle
Sukovas, Arturas
Paskauskas, Saulius
Bartusevicius, Arnoldas
Atstupenaite, Vaida
Svedas, Eimantas
Celiesiute, Joana
Cizauskas, Arvydas
Vaitkiene, Daiva
Gaurilcikas, Adrius
author_sort Gedgaudaite, Migle
collection PubMed
description Background and objectives. Systematic pelvic lymphadenectomy (LND) is an essential part of lymph-node status evaluation in endometrial cancer (EC) patients to tailor the adjuvant treatment. However, it is associated with the post-operative lymphatic complications and does not improve the outcomes of the disease. Indocyanine green (ICG) mapped sentinel lymph-node biopsy (SLB) has recently been introduced into the clinical practice as an alternative for the surgical lymph-node evaluation in EC patients with the potential to decrease LND related complications. The aim of our study was to evaluate the feasibility of ICG mapped SLB in low, intermediate, and high-risk EC patients in a center with no previous experience on endoscopic SLB procedure. Materials and Methods: The prospective study was performed. 170 patients with histologically confirmed EC were included. Sentinel lymph-nodes (SLs) were mapped with ICG dye and removed ahead of the total laparoscopic hysterectomy. Low-risk patients received only SLB, while SLB and LND were performed for intermediate and high-risk patients. Results: The overall detection rate of SLs was 88.8%. Bilateral mapping was achieved in 68.2% of the patients. The overall detection rate for low-risk patients was 93.7%, 85.0% for the intermediate-risk group, and 100% for high-risk patients (p = 0.232). The most common anatomical sites of SLs were the external iliac (45.8% on the right and 46.6% on the left) and obturator regions (20.9% and 25.6%, respectively). Positive lymph-nodes were found in 8 (4.7%) patients. The sensitivity of SLB was 75.0% and negative predictive value (NPV)—97.2%. Conclusions: Even in the center with no previous experience, sentinel lymph-node biopsy using ICG mapping is feasible. However, the favorable outcomes might be associated with the learning process of newly established method.
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spelling pubmed-92274272022-06-25 The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study Gedgaudaite, Migle Sukovas, Arturas Paskauskas, Saulius Bartusevicius, Arnoldas Atstupenaite, Vaida Svedas, Eimantas Celiesiute, Joana Cizauskas, Arvydas Vaitkiene, Daiva Gaurilcikas, Adrius Medicina (Kaunas) Article Background and objectives. Systematic pelvic lymphadenectomy (LND) is an essential part of lymph-node status evaluation in endometrial cancer (EC) patients to tailor the adjuvant treatment. However, it is associated with the post-operative lymphatic complications and does not improve the outcomes of the disease. Indocyanine green (ICG) mapped sentinel lymph-node biopsy (SLB) has recently been introduced into the clinical practice as an alternative for the surgical lymph-node evaluation in EC patients with the potential to decrease LND related complications. The aim of our study was to evaluate the feasibility of ICG mapped SLB in low, intermediate, and high-risk EC patients in a center with no previous experience on endoscopic SLB procedure. Materials and Methods: The prospective study was performed. 170 patients with histologically confirmed EC were included. Sentinel lymph-nodes (SLs) were mapped with ICG dye and removed ahead of the total laparoscopic hysterectomy. Low-risk patients received only SLB, while SLB and LND were performed for intermediate and high-risk patients. Results: The overall detection rate of SLs was 88.8%. Bilateral mapping was achieved in 68.2% of the patients. The overall detection rate for low-risk patients was 93.7%, 85.0% for the intermediate-risk group, and 100% for high-risk patients (p = 0.232). The most common anatomical sites of SLs were the external iliac (45.8% on the right and 46.6% on the left) and obturator regions (20.9% and 25.6%, respectively). Positive lymph-nodes were found in 8 (4.7%) patients. The sensitivity of SLB was 75.0% and negative predictive value (NPV)—97.2%. Conclusions: Even in the center with no previous experience, sentinel lymph-node biopsy using ICG mapping is feasible. However, the favorable outcomes might be associated with the learning process of newly established method. MDPI 2022-05-26 /pmc/articles/PMC9227427/ /pubmed/35743975 http://dx.doi.org/10.3390/medicina58060712 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gedgaudaite, Migle
Sukovas, Arturas
Paskauskas, Saulius
Bartusevicius, Arnoldas
Atstupenaite, Vaida
Svedas, Eimantas
Celiesiute, Joana
Cizauskas, Arvydas
Vaitkiene, Daiva
Gaurilcikas, Adrius
The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study
title The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study
title_full The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study
title_fullStr The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study
title_full_unstemmed The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study
title_short The Feasibility of Sentinel Lymph-Node, Mapped with Indocyanine Green, Biopsy in Endometrial Cancer Patients: A Prospective Study
title_sort feasibility of sentinel lymph-node, mapped with indocyanine green, biopsy in endometrial cancer patients: a prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227427/
https://www.ncbi.nlm.nih.gov/pubmed/35743975
http://dx.doi.org/10.3390/medicina58060712
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