Sentinel nodes detection with near-infrared imaging in gynecological cancer patients: Ushering in an era of precision medicine

Ahmet Namazov, Vladislav Volchok, Alejandro Liboff, Michael Volodarsky, Viki Kapustian, Eyal Y. Anteby, Ofer Gemer

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: The sentinel lymph node (SLN) biopsy procedure is a well-known method for identifying solid tumors such as breast cancer, vulvar cancer, and melanoma. In endometrial and cervical cancer, SLN has recently gained acceptance. Objectives: To evaluate the detection rate of SLN with an indocyanine green and near-infrared fluorescent imaging (ICG/NIR) integrated laparoscopic system in clinically uterine-confined endometrial or cervical cancer. Methods: Patients with clinically early-stage endometrial or cervical cancer were included in this retrospective study. ICG was injected into the uterine cervix and an ICG/NIR integrated laparoscopic system was used during the surgeries. The National Comprehensive Cancer Network (NCCN) protocol was followed. SLN and/or suspicious lymph nodes were resected. Side-specific lymphadenectomy was performed when mapping was unsuccessful. Systematic lymphadenectomy was completed in patients with high-grade histology or deep myometrial invasion. Enhanced pathology using ultra-staging and immunohistochemistry were performed in all cases. Results: We analyzed 46 eligible patients: 39 endometrial and 7 cervical cancers. Of these, 44 had at least one SLN (93.6%). In 41 patients (89%) we detected bilateral SLN, in 3 (7%) only unilateral, and in 2 (4%) none were detected. Seven patients presented with lymph node metastasis. All were detected by NCCN/SLN protocol. Of these cases, two were detected with only pathological ultra-staging. Conclusions: SLN mapping in endometrial and cervical cancer can easily be performed with a high detection rate by integrating ICG/NIR into a conventional laparoscopic system. Precision medicine in patients evaluated by SLN biopsy changes the way patients with endometrial or cervical cancer are managed.

Original languageEnglish
Pages (from-to)390-393
Number of pages4
JournalIsrael Medical Association Journal
Volume21
Issue number6
StatePublished - 1 Jun 2019

Keywords

  • Cervical cancer
  • Endometrial cancer
  • Indocyanine green (ICG)
  • Laparoscopy
  • Sentinel lymph node (SLN)

ASJC Scopus subject areas

  • General Medicine

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