title: Sentinel Node Mapping in Cervical and Endometrial Cancer: Indocyanine Green Versus Other Conventional Dyes-A Meta-Analysis.
abstract: Historically, blue dyes, (99)Tc or a combination of the two tracers have been used for sentinel lymph node (SLN) mapping in cervical and endometrial cancer patients. Indocyanine green (ICG), as a tracer, has been recently introduced in this setting. Our goal was to assess the differences in overall and bilateral detection rates as well as in false-negative rates among the different tracers.
  
  
  
  The electronic databases PubMed, MEDLINE, and Scopus were searched in January 2016 by searching the terms "sentinel lymph node" and "dye" and "indocyanine green," and "cervical cancer" or "endometrial cancer." Series comparing different tracers injected intracervically and reporting the detection rate and/or SLN false-negative rate were selected.
  
  
  
  Forty-five studies were retrieved. Six studies including 538 patients met selection criteria. Compared with blue dyes, ICG SLN mapping had higher overall (odds ratio [OR] 0.27; 95 % confidence interval [CI] 0.15-0.50; p < 0.0001) and bilateral detection rates (OR 0.27; 95 % CI 0.19-0.40; p < 0.00001). No differences were found between ICG and (99)TC, although these results are based on data of a single series. No differences in overall and bilateral detection rates were found between ICG and the combination of blue dyes and (99)TC. The pooled analysis of false-negative rates data showed no difference in false-negative rates between tracers.
  
  
  
  In cervical and endometrial cancer, ICG SLN mapping seems to be equivalent to the combination of blue dyes and (99)TC in terms of overall and bilateral detection rates. Its safety profile and ease of use may favor its employment respect to conventional tracers.
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.|Department of Gynecology, Campus Virchow Clinic, Charité Medical University, Berlin, Germany.
authors.forename: Ilary
authors.initials: I
authors.lastname: Ruscito
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy. marialuisa.gasparri@uniroma1.it.|Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland. marialuisa.gasparri@uniroma1.it.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Gasparri
authors.affiliation: Department of Gynecology, Campus Virchow Clinic, Charité Medical University, Berlin, Germany.
authors.forename: Elena Ioana
authors.initials: EI
authors.lastname: Braicu
authors.affiliation: Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Luigi
authors.initials: L
authors.lastname: Raio
authors.affiliation: Department of Gynecology, Campus Virchow Clinic, Charité Medical University, Berlin, Germany.
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.
authors.forename: Pierluigi Benedetti
authors.initials: PB
authors.lastname: Panici
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Papadia
mesh_terms: D004396:Coloring Agents; D016889:Endometrial Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008207:Lymphatic Metastasis; D000071036:Sentinel Lymph Node / Q000473:pathology*; D013667:Technetium
chemical_list: D004396:Coloring Agents; D013667:Technetium; D007208:Indocyanine Green