Indocyanine Green Sentinel Lymph Node Mapping as a Tool for Personalized Surgical Management in Uterine Corpus Cancer: A Single-Center Comparative Study

TL;DR

This study shows that using indocyanine green for sentinel lymph node mapping in uterine cancer surgery is safe and leads to fewer complications and shorter hospital stays compared to other lymph node procedures.

Contribution

The study provides evidence that sentinel lymph node mapping with ICG is a safer alternative to traditional lymph node dissection in uterine corpus cancer.

Findings

SLN mapping had a 0% complication rate and shorter hospital stays compared to other lymph node procedures.

Obesity was associated with higher complication rates and fewer lymph nodes resected.

Successful ICG injection and SLN mapping were more frequent in the SLN group.

Abstract

Objectives: This study aimed to investigate the usefulness and safety of sentinel lymph node (SLN) mapping in comparison to other types of lymph node dissection in patients with uterine corpus cancers. Methods: Retrospective data from 161 patients subjected to uterine corpus cancer staging with SLN mapping with indocyanine green (ICG) dye were collected. Results: SLN procedure was associated with a complication rate of 0%, a median number of dissected lymph nodes of 2 (range 0–13), and a median hospitalization following surgery of 5 (range:2–23) days. Systemic lymphadenectomy and one-sided pelvic lymph node resection were associated with the highest percentage of complications (12% and 25%; p = 0.0030), while the post-surgery course was uneventful for the selective lymphadenectomy group and SLN. Complication rates were the highest in patients with obesity and severe obesity (5.1% and 9.1%, respectively). The number of lymph nodes resected dropped numerically with increasing BMI. Successful ICG injection and SLN mapping were significantly more frequent in SLN procedures. Conclusions: Our study showed that SLN mapping was characterized by a low complication rate and short hospitalization following surgery, and obesity appeared to be related to a higher complication rate. Tailored surgical strategies and individualized patient selection are crucial for the success of SLN mapping; therefore, factors associated with successful SLN mapping with ICG need further exploration.

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