Sentinel node biopsy for diagnosis of lymph node involvement in endometrial cancer

Nagar, Hans; Wietek, Nina; Goodall, Richard; Schmidt‐Hansen, Mia; Morrison, Jo

doi:10.1002/14651858.cd013021.pub2

Cited by 32 publications

(38 citation statements)

References 237 publications

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“… 21 According to the most recent systematic review by Nagar et al, indocyanine green tracer has a better detection rate (sentinel lymph node mapping rate of 92.4%, range 88.7–96.2%; pooled sensitivity 92.5%) compared with a combination of technecium-99m with blue dye (86.3%, range 80.7–91.9%; pooled sensitivity 91.9%). 22 A similar trend in improving the bilateral mapping rate in robotic endometrial cancer surgery with indocyanine green tracer was also reported by Tucker et al but the authors concluded that rates stabilized after 40 cases. The authors also addressed another important issue, the rate of removed specimens containing lymphatic tissue.…”

Section: Discussionsupporting

confidence: 68%

“…In agreement with our results, the minimal number of 30 procedures was also suggested by Khoury Collado et al but their study was conducted using a combination of blue dye with radiolabelled technecium-99m 21. According to the most recent systematic review by Nagar et al, indocyanine green tracer has a better detection rate (sentinel lymph node mapping rate of 92.4%, range 88.7–96.2%; pooled sensitivity 92.5%) compared with a combination of technecium-99m with blue dye (86.3%, range 80.7–91.9%; pooled sensitivity 91.9%) 22. A similar trend in improving the bilateral mapping rate in robotic endometrial cancer surgery with indocyanine green tracer was also reported by Tucker et al but the authors concluded that rates stabilized after 40 cases.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic sentinel lymph node mapping with indocyanine green in endometrial cancer: surgeon’s learning curve (cumulative sum analysis)

Gedgaudaitė

Paskauskas²,

Bartusevičius³

et al. 2023

Int J Gynecol Cancer

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ObjectivesTo evaluate surgeons’ learning curves for laparoscopic sentinel lymph node biopsy in endometrial cancer.MethodsA prospective observational study was performed at the Oncogynecology Center, Lithuanian University of Health Sciences Hospital, from March 2018 to October 2022. Participating surgeons had no previous experience of laparoscopic sentinel lymph node biopsy with indocyanine green tracer. Cumulative sum analysis was used to create learning curves for the performance of eight surgeons, based on a specific result over a time period. Two different cumulative sum plots were made for each surgeon: successful bilateral sentinel lymph node mapping and removal of sentinel lymph node specimens containing actual lymphatic tissue.Results190 patients were included. The overall rate of sentinel lymph node mapping was 89.5%: successful bilateral mapping was achieved in 134 (70.5%) patients, while in 36 (19%) patients sentinel lymph nodes were mapped unilaterally. The bilateral detection rate significantly improved in later study periods (from 59.3% in the first year to 85.0% in the last year; p=0.03). Analysis of the performance of the surgeons for bilateral sentinel lymph node mapping showed that the cumulative sum plot crossed the H0limit line after 13 consecutive successful bilateral sentinel lymph node biopsies, indicating an acceptable level of competence to achieve the bilateral detection rate of at least 75%. This was accomplished by only one surgeon after 30 surgeries. Analysis of the performance of the surgeons for identification and removal of specimens containing histologically confirmed lymphatic tissue showed that the cumulative sum plots crossed the H0limit line after six consecutive successful sentinel lymph node removals. This was accomplished by most of the surgeons (5 of 8).ConclusionAt least 30 procedures of indocyanine green traced laparoscopic sentinel lymph node biopsy were needed to reach an acceptable level of competence for a bilateral sentinel lymph node detection rate of at least 75%.Trial registration numberACTRN12619000979156.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Laparoscopic sentinel lymph node mapping with indocyanine green in endometrial cancer: surgeon’s learning curve (cumulative sum analysis)

Gedgaudaitė

Paskauskas²,

Bartusevičius³

et al. 2023

Int J Gynecol Cancer

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“…Sentinel lymph nodes refer to the first group of lymph nodes that drain the primary tumor lymph, which is the first area involved when the tumor metastasis occurs, reflecting the state of lymph node involvement in the entire region ( 6 – 8 ). SLN mapping is used to determine whether the tumor has developed lymphatic metastases.…”

Section: Introduction To Sentinel Lymph Node Techniquesmentioning

confidence: 99%

Sentinel Lymph Node Mapping: Current Applications and Future Perspectives in Gynecology Malignant Tumors

Wang

Shao

et al. 2022

Front. Med.

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The sentinel lymph nodes (SLNs) is a group of lymph nodes initially involved in the metastatic spread of cancer cells. SLN mapping refers to intraoperative localization and biopsy of SLNs with specific tracers to assess lymph node metastases. It is widely used in a variety of tumor surgeries for its high sensitivity and high negative predictive value. In the evaluation of the status of lymph node metastases in gynecological malignancies, it has received increasingly more attention due to its minor invasiveness, few complications, and high diagnosis rate. The National Comprehensive Cancer Network (NCCN) guidelines provide an excellent introduction to the indications and methods of SLN techniques in vulvar, cervical, and endometrial cancers, but they provide little explanation about some specific issues. In this review, we summarize different dyes and injection methods and discuss the indications of application and the clinical trials of SLN mapping in gynecological malignant tumors, aiming to provide a reference for the rational application of sentinel techniques in gynecology malignant tumors before relevant guidelines are updated.

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“…Various tracers, including radioactive tracers and dyes, have been used to identify the sentinel lymph node and assess for tumor involvement, all with similar detection rates ( Nagar, 2021 ). In a large, multicenter prospective trial, detection rates for SLNs in minimally invasive surgery for early stage endometrial cancer using indocyanine green (ICG) alone have been reported as 52 % bilaterally and 86 % overall ( Rossi, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Technetium Tc 99m tilmanocept fails to detect sentinel lymph nodes in endometrial cancer

Reddy¹,

Moon²,

Chow³

et al. 2022

Gynecologic Oncology Reports

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Sentinel node biopsy for diagnosis of lymph node involvement in endometrial cancer

Cited by 32 publications

References 237 publications

Laparoscopic sentinel lymph node mapping with indocyanine green in endometrial cancer: surgeon’s learning curve (cumulative sum analysis)

Laparoscopic sentinel lymph node mapping with indocyanine green in endometrial cancer: surgeon’s learning curve (cumulative sum analysis)

Sentinel Lymph Node Mapping: Current Applications and Future Perspectives in Gynecology Malignant Tumors

Technetium Tc 99m tilmanocept fails to detect sentinel lymph nodes in endometrial cancer

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