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A retrospective validation study of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer
20 September 2018 (online)
To evaluate the sensitivity, negative predictive value (NPV) and false negative (FN) rate of the Near Infrared (NIR) indocyanine green (ICG) sentinel lymph node (SLN) mapping in patients with high grade endometrial cancer who have undergone a full pelvic and para-aortic lymphadenectomy after SLN mapping.
Retrospective analysis of patients with endometrial cancer undergoing a laparoscopic NIR-ICG SLN mapping followed by a systematic pelvic and para-aortic lymphadenectomy. Inclusion criteria were a grade 3 endometrial cancer or a high risk histology (papillary serous, clear cell carcinoma, carcinosarcoma and neuroendocrine carcinoma) and a completion pelvic and para-aortic lymphadenectomy to the renal vessels after SLN mapping. Overall and bilateral detection rates, sensitivity, negative predictive value and false negative rates were calculated.
From December 2012 until January 2017, 42 patients fulfilled inclusion criteria. Overall and bilateral detection rates were 100% and 90.5% respectively. Overall, 23.8% of the patients had lymph node metastases. In one patient, despite negative bilateral pelvic SLNs, a metastatic non SLN was detected. This was the only false negative case resulting in a false negative rate of 10% Sensitivity and NPV were 90% and 97.1% respectively.
NIR-ICG SLN mapping yields high overall and bilateral detection rates and an acceptable false negative rate in high risk endometrial cancer patients and could therefore be safely adopted in this setting.