Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer

Benito Chiofalo, Antonio Simone Laganà (), Fabio Ghezzi, Camilla Certelli, Jvan Casarin, Valentina Bruno, Isabella Sperduti, Vito Chiantera, Panagiotis Peitsidis and Enrico Vizza
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Benito Chiofalo: Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
Antonio Simone Laganà: Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
Fabio Ghezzi: Department of Obstetrics and Gynecology, “Filippo Del Ponte” Women and Children Hospital, University of Insubria, 21100 Varese, Italy
Camilla Certelli: Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
Jvan Casarin: Department of Obstetrics and Gynecology, “Filippo Del Ponte” Women and Children Hospital, University of Insubria, 21100 Varese, Italy
Valentina Bruno: Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
Isabella Sperduti: Biostatistical Unit, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
Vito Chiantera: Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
Panagiotis Peitsidis: Department of Obstetrics and Gynecology, Helena Venizelou Hospital, 115 21 Athens, Greece
Enrico Vizza: Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy

IJERPH, 2023, vol. 20, issue 4, 1-11

Abstract: Background: The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC). Methods: This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study. Results: The two groups were homogeneous for age ( p = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages ( p = 0.41 for EC; p = 0.17 for CC), median estimated blood loss ( p = 0.76), median operative time ( p = 0.59), and perioperative complications ( p = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher ( p = 0.005) in the ICG group ( n = 18) compared with controls ( n = 16). Conclusions: The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.

Keywords: gynecologic oncology; minimally invasive surgery; indocyanine green; endometrial cancer; cervical cancer; robotic surgery; laparoscopy; pelvic lymphadenectomy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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