Sentinel Lymph Node Mapping with Indocyanine Green in Endometrial Cancer: Does the Minimally Invasive Platform...

Area of Science:

• Gynecologic Oncology
• Surgical Technology
• Cancer Diagnostics

Background:

• Sentinel lymph node (SLN) mapping is crucial for staging early-stage endometrial cancer.
• Indocyanine green (ICG) is an effective tracer for SLN identification.
• Comparing surgical modalities for SLN mapping is essential for optimizing patient outcomes.

Purpose of the Study:

• To compare the efficacy of indocyanine green (ICG) sentinel lymph node (SLN) mapping between conventional laparoscopy and robot-assisted surgery.
• To evaluate SLN detection rates and patterns in apparent early-stage endometrial cancer.
• To assess the impact of surgical approach on hospital stay and postoperative complications.

Main Methods:

• Retrospective analysis of 169 patients undergoing minimally invasive surgery with SLN mapping.
• Standardized intracervical ICG injection protocol with predefined failure management.
• Ultrastaging of all SLN specimens; multivariable logistic and median regression analyses.

Main Results:

• No significant difference in SLN detection rates between laparoscopic (90.3%) and robotic (91.6%) surgery (p=1.000).
• Robot-assisted surgery was associated with a significantly shorter hospital stay (30.0 vs 49.0 hours, p<0.001).
• Operative time, blood loss, and postoperative complication rates were comparable between the two groups.

Conclusions:

• Indocyanine green SLN mapping demonstrates comparable performance in both laparoscopic and robot-assisted surgery for early-stage endometrial cancer.
• Robot-assisted surgery offers a potential benefit of reduced hospital length of stay.
• Standardized protocols and ultrastaging are key for reliable SLN mapping outcomes.