Sentinel-lymph-node mapping with indocyanine green in robotic-assisted laparoscopic surgery for early endometrial cancer: a retrospective analysis.
Gynecological malignancy
indocyanine green
lymphadenectomy
robotic surgery
surgical staging
Journal
Facts, views & vision in ObGyn
ISSN: 2032-0418
Titre abrégé: Facts Views Vis Obgyn
Pays: Belgium
ID NLM: 101578773
Informations de publication
Date de publication:
27 Mar 2020
27 Mar 2020
Historique:
entrez:
24
4
2020
pubmed:
24
4
2020
medline:
24
4
2020
Statut:
epublish
Résumé
The therapeutic value of lymphadenectomy in early stage endometrial cancer (EC) is still debated. Sentinel-lymph-node identified with indocyanine green (ICG) can replace lymphadenectomy in the staging of endometrial cancer minimizing the potential morbidity of a complete lymphadenectomy. The aim of this study was to analyze our initial experience using indocyanine green for sentinel-lymph-node mapping in a minimally robotic-assisted laparoscopic approach with Da Vinci XI near-infrared (NIR) fluorescence imaging system. A total of 23 patients who underwent robot-assisted laparoscopic surgery with the Da Vinci Xi Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) with NIR imaging and ICG fluorescence detection for early stage EC were retrospectively analyzed. Sentinel-lymph-node mapping was achieved in 18 patients for a detection rate of 78.26%, bilateral pelvic detection was possible in 14 patients (60.9%) and no sentinel-lymph-node mapping was noted in 4 patients (17.4%). We compared 11 patients (Group 1) at intermediate and high- risk of recurrence who underwent sentinel-lymph- node mapping and pelvic lymphadenectomy and 12 patients (Group 2) at low risk of recurrence who underwent only sentinel-lymph-node mapping. A statistically significant difference was found for the average operation time and for the hospital stays. The high detection rate, absence of intraoperative or postoperative complications, the short time required for mapping and removal of the sentinel-lymph-nodes and the short duration of the hospital stay, support performing sentinel-lymph-node in all women with early endometrial cancer.
Sections du résumé
BACKGROUND
BACKGROUND
The therapeutic value of lymphadenectomy in early stage endometrial cancer (EC) is still debated. Sentinel-lymph-node identified with indocyanine green (ICG) can replace lymphadenectomy in the staging of endometrial cancer minimizing the potential morbidity of a complete lymphadenectomy. The aim of this study was to analyze our initial experience using indocyanine green for sentinel-lymph-node mapping in a minimally robotic-assisted laparoscopic approach with Da Vinci XI near-infrared (NIR) fluorescence imaging system.
METHODS
METHODS
A total of 23 patients who underwent robot-assisted laparoscopic surgery with the Da Vinci Xi Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) with NIR imaging and ICG fluorescence detection for early stage EC were retrospectively analyzed.
RESULTS
RESULTS
Sentinel-lymph-node mapping was achieved in 18 patients for a detection rate of 78.26%, bilateral pelvic detection was possible in 14 patients (60.9%) and no sentinel-lymph-node mapping was noted in 4 patients (17.4%). We compared 11 patients (Group 1) at intermediate and high- risk of recurrence who underwent sentinel-lymph- node mapping and pelvic lymphadenectomy and 12 patients (Group 2) at low risk of recurrence who underwent only sentinel-lymph-node mapping. A statistically significant difference was found for the average operation time and for the hospital stays.
CONCLUSIONS
CONCLUSIONS
The high detection rate, absence of intraoperative or postoperative complications, the short time required for mapping and removal of the sentinel-lymph-nodes and the short duration of the hospital stay, support performing sentinel-lymph-node in all women with early endometrial cancer.
Types de publication
Journal Article
Langues
eng
Pagination
323-328Informations de copyright
Copyright © 2019 Facts, Views & Vision.
Références
Gynecol Oncol. 2012 Jul;126(1):5-11
pubmed: 22555109
Lancet. 2009 Jan 10;373(9658):125-36
pubmed: 19070889
Gynecol Oncol. 2015 Jun;137(3):436-42
pubmed: 25870917
Gynecol Oncol. 2014 May;133(2):274-7
pubmed: 24582865
Cancer. 2006 Oct 15;107(8):1823-30
pubmed: 16977653
Gynecol Oncol. 2012 Jun;125(3):531-5
pubmed: 22366409
Arch Gynecol Obstet. 2015 Apr;291(4):897-905
pubmed: 25315381
J Minim Invasive Gynecol. 2018 Mar - Apr;25(3):455-460
pubmed: 29032256
Gynecol Oncol. 2017 May;145(2):256-261
pubmed: 28196672
J Natl Cancer Inst. 2008 Dec 3;100(23):1707-16
pubmed: 19033573
Eur J Surg Oncol. 2016 Oct;42(10):1506-11
pubmed: 27612413
Gynecol Oncol. 2013 Dec;131(3):714-9
pubmed: 24099838
Am J Obstet Gynecol. 2017 May;216(5):459-476.e10
pubmed: 27871836
Gynecol Oncol. 2012 Jul;126(1):25-9
pubmed: 22507531
Int J Gynecol Cancer. 2013 Nov;23(9):1704-11
pubmed: 24177256
Gynecol Oncol. 2014 Aug;134(2):281-6
pubmed: 24882555
Ann Surg Oncol. 2013 Feb;20(2):407-12
pubmed: 23054119
Ann Oncol. 2016 Jan;27(1):16-41
pubmed: 26634381
Cancer. 2014 Dec 1;120 Suppl 23:3836-45
pubmed: 25412395
Oncotarget. 2017 Jul 11;8(28):46601-46610
pubmed: 28410225
Lancet Oncol. 2017 Mar;18(3):384-392
pubmed: 28159465
Gynecol Oncol. 2017 Aug;146(2):405-415
pubmed: 28566221
Eur J Surg Oncol. 2018 Dec;44(12):1935-1941
pubmed: 30245146
Bull Cancer. 2017 Dec;104(12):1032-1038
pubmed: 29173977
Gynecol Oncol. 2012 Jan;124(1):78-82
pubmed: 21996262
Arch Gynecol Obstet. 2014 Dec;290(6):1187-93
pubmed: 24981050
Ann Surg Oncol. 2016 Jul;23(7):2183-91
pubmed: 26714944
Gynecol Oncol. 2016 Dec;143(3):479-483
pubmed: 27776838
J Natl Compr Canc Netw. 2018 Feb;16(2):170-199
pubmed: 29439178
Gynecol Oncol. 2011 Aug;122(2):251-4
pubmed: 21570109