Maximizing sentinel node detection in endometrial cancer with dual cervical and transcervical fundal indocyanine green injection: 5-year single-center prospective study

Ruiz, Rubén; Gorostidi, Mikel; Jaunarena, Ibón; Cobas, Paloma; Lekuona, Arantxa

doi:10.1016/j.ejogrb.2021.04.015

Cited by 10 publications

(12 citation statements)

References 27 publications

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“…and 0%, respectively. The comparable results are reported by Ruiz et al 20 that the sensitivity of detection was 97.9% and negative predictive value 99.5% with a dual cervical and fundal indocyanine green injection.…”

Section: Discussionsupporting

confidence: 90%

“…The NPVs were 99.0% and 100.0%, and the FNRs were 8.3% and 0%, respectively. The comparable results are reported by Ruiz et al 20 that the sensitivity of detection was 97.9% and negative predictive value 99.5% with a dual cervical and fundal indocyanine green injection. Comparing with these two studies, our combined injection was a cervical injection followed by fundal injection, which might lead to the inability to distinguish SLNs draining from the fundus of the uterus to the para‐aortic areas because of lymphatic drainage from the cervix to the para‐aortic areas.…”

Section: Discussionsupporting

confidence: 90%

“…In addition to the higher para-aortic SLN detection rate, our data validated that the combined injection had relatively higher sensitivity, FNR, and NPV than the cervical injection without statistical significance, which might be due to small sample sizes. The two-step injection method adopted by Kim et al 21 and the dual-injection method reported by Ruiz et al 20 might be comparable with our combined method. In Kim's work, ICG was injected into the corneal area of both sides of the uterus.…”

Section: Discussionsupporting

confidence: 63%

“…The detection rate of lower and upper para-aortic SLNs were 67.1% and 38.2% in the two-step, while 18.7% and 5.7% in the one-step group (p < 0.001). Recently, the effectiveness of dual cervical and fundal indocyanine green injection for SLN biopsy has also been exemplified in a prospective single-arm study by Ruben et al 20 with a para-aortic SLN detection rate of 66.9%.…”

Section: Discussionmentioning

confidence: 99%

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The efficiency of a combined injection technique for sentinel lymph node mapping in intermediate‐high‐risk endometrial cancer

Wang

et al. 2021

Journal of Surgical Oncology

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Background and Objectives Sentinel lymph node (SLN) mapping was considered for treating endometrial cancer (EC) which was apparent confined to the uterus. Nevertheless, intermediate‐high‐risk EC patients have super high risk to undergo isolated para‐aortic lymph node metastases comparing with low‐risk patients. Therefore, this investigation aimed to compare the efficacy of two SLN methods in detecting para‐aortic lymph node metastases. Methods According to SLN mapping injection methods, intermediate‐high‐risk EC patients who received both SLN mapping and systematic lymphadenectomy were divided into the combined group (fundal and cervical injections) and the cervical group (cervical injection only). Results The para‐aortic SLN detection rate in the combined group (40.4%) was higher than that in the cervical group (4.4%) with p < 0.001. While the differences concerning the sensitivity, false‐negative rate, and negative predictive value between the two groups were not significant. The survival outcomes of patients were comparable between the two groups. Conclusion Our data showcased that the combined (fundal and cervical) injection had a higher detection rate of para‐aortic SLNs than cervical injection only. The efficiency of SLN mapping and the survival outcomes were not significantly different between the two groups. Further investigations are warranted to assess the value of combined injection regarding SLN technique.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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The efficiency of a combined injection technique for sentinel lymph node mapping in intermediate‐high‐risk endometrial cancer

Wang

et al. 2021

Journal of Surgical Oncology

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“…Previous studies from Korea utilized a two-step SLN mapping, which showed a high detection rate of para-aortic SLN and was 67% in the lower para-aortic region and 38% in the upper para-aortic region [8]. A more recent study by Ruiz et al [47] that examined 278 patients who were administered dual injection for 5 years, reported a similar para-aortic SLN detection rate of 65% [48]. Some authors have stated that isolated paraaortic metastasis is frequently accompanied by overlooked metastasis or micrometastasis in the pelvic lymph nodes.…”

Section: Methods Of Fine-tuning Sln Mapping With Respect To Paraaorti...mentioning

confidence: 99%

Sentinel lymph node biopsy in high-risk endometrial cancer: performance, outcomes, and future avenues

Kim

2022

Obstet Gynecol Sci

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Endometrial cancer is the second most common gynecological malignancy worldwide, with an overall favorable prognosis. However, a subgroup of patients has a high risk of recurrence and poor prognosis. This review summarizes recently published articles that examined sentinel lymph node (SLN) biopsy in patients with high-risk endometrial cancer. We focused on the performance and outcomes of SLN biopsy, and examined potential methods for improving the management of this high-risk subset. Few studies have examined the long-term outcomes of SLN in patients with high-risk endometrial cancer.Thus, we reviewed recently published retrospective studies that have adopted statistical techniques, such as inverse probability weighting or propensity score matching, to examine the outcome of SLN biopsy compared to conventional lymphadenectomy. Potential avenues for future research to fine-tune decision making for this patient subgroup were also discussed.

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Robotic para-aortic sentinel lymph node mapping in endometrial, cervical, and ovarian cancer

Trappen

2023

Best Practice & Research Clinical Obstetrics & Gynaecol

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Maximizing sentinel node detection in endometrial cancer with dual cervical and transcervical fundal indocyanine green injection: 5-year single-center prospective study

Cited by 10 publications

References 27 publications

The efficiency of a combined injection technique for sentinel lymph node mapping in intermediate‐high‐risk endometrial cancer

The efficiency of a combined injection technique for sentinel lymph node mapping in intermediate‐high‐risk endometrial cancer

Sentinel lymph node biopsy in high-risk endometrial cancer: performance, outcomes, and future avenues

Robotic para-aortic sentinel lymph node mapping in endometrial, cervical, and ovarian cancer

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