Indocyanine green utility in sentinel node detection for cervical cancer patients

Abstract

With wide implementation of screening tests for the Human Papilloma Virus, the number of diagnosed cases of premalignant or early stages of cervical cancer has increased considerably. As a consequence, surgeons' attention has focused on determining how best to limit the surgical procedure so the benefits of the procedure will not be surpassed by postoperative morbidity. In this respect, extended lymph node dissection, routinely associated so far with cervical cancer patients, has in the last decades been replaced with sentinel node detection and biopsy. Initially performed through radiocolloid injection, this method has undergone permanent changes in order to maximize its efficacy and safety. Although the laparoscopic approach had been widely used in the past, a new method has been proposed, i.e., the use of indocyanine green injection, which has yielded promising results for sentinel node detection in the early stages of cervical carcinoma. This paper reviews the literature of the most relevant studies conducted on this topic.

Utility of indocyanine green injection in patients with cervical cancer besides the identification of sentinel lymph node (Review)

“…Cervical cancer still represents a serious health problem affecting women worldwide, even though screening tests have been widely implemented (1)(2)(3)(4). Although the number of cases diagnosed in advanced stages of the disease reported a slight decrease in the last decade (5)(6)(7), the wide presence of human papilloma virus infection in population is still responsible for a significant number of newly diagnosed cases annually.…”

“…Although the number of cases diagnosed in advanced stages of the disease reported a slight decrease in the last decade (5)(6)(7), the wide presence of human papilloma virus infection in population is still responsible for a significant number of newly diagnosed cases annually. Therefore, a significant number of cases are diagnosed in early stages of the disease when less invasive surgical procedures are feasible in order to achieve a good local control of the disease (1)(2)(3). In this respect attention was focused on elaborating new therapeutic strategies in order to provide an effective treatment which is able to preserve fertility and functionality of the genital function and, moreover, to assure a good oncological long-term outcome (8)(9)(10)(11)(12).…”

“…In this respect attention was focused on elaborating new therapeutic strategies in order to provide an effective treatment which is able to preserve fertility and functionality of the genital function and, moreover, to assure a good oncological long-term outcome (8)(9)(10)(11)(12). The method of detection of the sentinel node, which is considered to be the first involved lymph node in a neoplastic disease and which, if identified, retrieved and analyzed might orientate the lymphatic extension of the disease, and might influence the choice of adjuvant therapy has gained significant popularity in the last decades in the field of gynecologic oncology, large studies have been published on this issue (3,4,11,12). In cervical cancer, the method has been included as part of the standard therapeutic strategy, being cited in worldwide recognized guidelines of treatment, such as National Comprehensive Cancer Network clinical practice guidelines in oncology (13) or European Society for Medical Oncology clinical practice guidelines (14).…”