Real-Time Fluorescent Sentinel Lymph Node Mapping with Indocyanine Green in Women with Previous Conization Undergoing Laparoscopic Surgery for Early Invasive Cervical Cancer: Comparison with Radiotracer ± Blue Dye.

Buda, Alessandro; Papadia, Andrea; Di Martino, Giampaolo; Imboden, Sara; Bussi, Beatrice; Guerra, Luca; De Ponti, Elena; Reato, Claudio; Gasparri, Maria Luisa; Crivellaro, Cinzia; Mueller, Michael (2018). Real-Time Fluorescent Sentinel Lymph Node Mapping with Indocyanine Green in Women with Previous Conization Undergoing Laparoscopic Surgery for Early Invasive Cervical Cancer: Comparison with Radiotracer ± Blue Dye. Journal of minimally invasive gynecology, 25(3), pp. 455-460. Elsevier 10.1016/j.jmig.2017.10.002

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STUDY OBJECTIVE To evaluate the added value of the fluorescence dye indocyanine green (ICG) for sentinel lymph node (SLN) mapping in women with cervical cancer who had undergone previous conization (stage 1A-1B1) by comparing ICG versus Tc99m radiotracer + blue dye (BD). DESIGN Retrospective study (Canadian Task Force classification II-2). SETTING Two European academic medical centers, San Gerardo Hospital, Italy and University of Berne, Switzerland. PATIENTS Sixty-five women with early stage (IA-IB1) cervical cancer who had undergone previous conization and who underwent SLN mapping with Tc99m ± BD (n = 23) or ICG (n = 42) followed by pelvic lymphadenectomy and fertility-sparing surgery or hysterectomy were included in this analysis. INTERVENTION Overall detection rate and bilateral SLN mapping rates of ICG were compared with those obtained using the standard Tc99m radiocolloid and BD. MEASUREMENT AND MAIN RESULTS Overall, 220 SLNs were detected. The median number of SLNs per patient in the Tc99m ± BD group was 2 (range, 1-5) and in the ICG group, 3 (range, 2-15). The detection rate of SLNs was 95.7% in Tc99m ± BD group and 100% in the ICG group (p = .354). The women injected with ICG had a higher rate of bilateral mapping of the SLNs as compared with the Tc99m ± BD group (95.2% vs 69.6%, p = .016%). Only 12% of the patients (8/65) presented metastatic nodes, 2 in the Tc99m ± BD group and 6 in the ICG group. CONCLUSION In early-stage cervical cancer patients conization had no significant impact on the SLN detection rate using both techniques (ICG and radiotracer ± BD). In this scenario a higher bilateral mapping rate was confirmed using the fluorescent dye ICG rather than the standard techniques.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Papadia, Andrea; Imboden, Sara and Mueller, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1553-4650

Publisher:

Elsevier

Language:

English

Submitter:

Monika Zehr

Date Deposited:

05 Mar 2018 14:42

Last Modified:

22 Nov 2019 07:18

Publisher DOI:

10.1016/j.jmig.2017.10.002

PubMed ID:

29032256

Uncontrolled Keywords:

Blue dye Cervical cancer Fluorescent real-time mapping Indocyanine green Radiocolloid Sentinel lymph node

BORIS DOI:

10.7892/boris.110895

URI:

https://boris.unibe.ch/id/eprint/110895

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