It was unclear how effective wat is to map sentinel lymph nodes (SLN) for high-risk endometrial cancer. This provoked the researchers to assess the negative predictive value (NPV), sensitivity, and false-negative (FN) rate of cervical injection of indocyanine green (ICG) SLN mapping in patients who were diagnosed with endometrial cancer.

This planned interventional study was performed at a single university teaching hospital. It comprised consecutive patients with early-stage endometrial cancer who had gone through laparoscopic surgical staging. All study patients had a cervical injection of ICG and near-infrared SLN identification and biopsy performed on themselves. This was followed by systematic pelvic lymphadenectomy. For all of the patients who had high-risk histologieshereas, para-aortic lymphadenectomy was performed. The researchers also calculated the sensitivity, sentinel lymph nodes detection rates, false-negative rates, and negative predictive value.

About 131 patients were enlisted in the 2-year time period from July 2016 to July 2018. However, 93.1% was the overall SLN detection rate; the bilateral detection rate was 61.8% and 4 positive SLNs were recognized in 4 patients. Lymph node metastasis was seen in 4 extra patients who did not have positive SLNs. These 4 extra patients were in a group of patients who had a high-risk subtype. Isolated para-aortic node metastases were found in 3 of the 4 patients. The sensitivity of the SLN method in distinguishing nodal metastatic disease was 100% (95% CI 31.0–100) in low-risk endometrial cancers with an FN rate and NPV of 0% and 100% (95% CI 95.1–100) respectively. The sensitivity in high-risk endometrial cancers was 20% (95% CI 1.0–70.1) while FN rate and NPV 80% and 83.3% (95% CI 61.8–94.5), respectively.

Low sensitivity and a high FN rate for distinguishing node metastasis in endometrial cancer with high-risk histologies were produced through cervical injection of ICG and SLN mapping.

Link:theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2019-0113