title: Sentinel Lymph Node Mapping With Near-Infrared Fluorescent Imaging Using Indocyanine Green: A New Tool for Laparoscopic Platform in Patients With Endometrial and Cervical Cancer.
abstract: Indocyanine green (ICG) represents a feasible alternative to the more traditional methods of sentinel lymph node (SLN) mapping, and interest in this promising tracer is growing. This report outlines our experience with ICG in a minimally invasive laparoscopic approach in women with endometrial cancer and cervical cancer using the Storz SPIES ICG near-infrared fluorescence imaging technology. A total of 49 patients with clinical stage I endometrial cancer (n = 40) or stage I cervical cancer (n = 9) were retrospectively reviewed. All patients had undergone simple or radical laparoscopic hysterectomy with pelvic and/or aortic lymphadenectomy and SLN mapping by means of an intracervical injection of ICG dye at the 3 o'clock and 9 o'clock locations after the induction of general anesthesia. The detection rate of ICG was 100% (49 of 49). The rate of bilateral SLN detection was 86% (42 of 49). Positive lymph nodes were found in 6 patients (12%), with at least 1 positive SLN. The sensitivity and negative predictive value of SLN detection were 100%. All procedures were successfully completed without conversion to open laparotomy, and no intraoperative or postoperative complications occurred. In our preliminary experience, ICG showed a high overall detection rate, and bilateral mapping appears to be a feasible alternative to the more traditional methods of SLN mapping in patients with endometrial cancer and cervical cancer. Laparoscopic SLN mapping with ICG appears to be safe, easy, and reproducible, with a positive impact on patient management.
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy. Electronic address: alebuda1972@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Buda
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bussi
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Di Martino
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Lorenzo
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy.
authors.forename: Sharon
authors.initials: S
authors.lastname: Palazzi
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Grassi
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca Monza, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents / Q000627:therapeutic use*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007208:Indocyanine Green / Q000627:therapeutic use*; D010535:Laparoscopy / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D061848:Optical Imaging / Q000379:methods; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: Cervical cancer; Endometrial cancer; Indocyanine Green; Laparoscopic surgery; Sentinel lymph node mapping