Visualization Methods for Uterine Sentinel Lymph Nodes in Early-Stage Endometrial Carcinoma: A Comparative Analysis

Area of Science:

• Gynecology
• Surgical Oncology
• Oncologic Imaging

Background:

• Sentinel lymph node (SLN) biopsy is preferred for early-stage endometrial cancer over systematic lymphadenectomy due to lower morbidity.
• Accurate SLN identification is crucial for staging and treatment planning.

Purpose of the Study:

• To compare the overall and bilateral detection rates of SLN using Indocyanine green (ICG), methylene blue (MB), and a combination (ICG+MB).

Main Methods:

• A prospective cohort study involving 99 patients with early-stage endometrial cancer.
• Three tracer groups were evaluated: ICG, MB, and ICG+MB.
• Comparison of mapping characteristics, detection rates, and number of SLNs identified.

Main Results:

• The overall SLN detection rate was 54.3% for MB, 72.7% for ICG, and 80.6% for ICG+MB.
• Bilateral detection rates were 22.9% (MB), 39.4% (ICG), and 54.8% (ICG+MB).
• The MB group showed significantly inferior results compared to the other groups.

Conclusions:

• Combining ICG and MB tracers enhances SLN identification accuracy in early-stage endometrial cancer.
• The ICG+MB combination demonstrated superior overall and bilateral detection rates.
• This combined approach increases accuracy without additional patient risk.