Sentinel Lymph Node Staging with Indocyanine Green for Patients with Cervical Cancer: The Safety and Feasibility of Open Approach Using SPY-PHI Technique

Journal of Clinical Medicine

Ahmad Sayasneh¹  Mustafa Zelal Muallem²  Andrea Miranda²  Robert Armbrust²  Jalid Sehouli² 

[1] Department of Gynecological Oncology, Surgical Oncology Directorate, Guy’s and St Thomas’ NHS Foundation Trust, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, Westminster Bridge Road, London SE1 7EH, UK;Department of Gynecology with Center for Oncological Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, Germany;

关键词: sentinel lymph node;    cervical cancer;    radical hysterectomy;    indocyanine green;    SPY-Portable Handheld Imager;    SPY-PHI;   

DOI  :  10.3390/jcm10214849

来源: DOAJ

【 摘 要 】

(1) Background: Sentinel lymph node staging (SLN) with indocyanine green (ICG) in cervical cancer is the standard of care in most national and international guidelines. However, the vast majority of relevant studies about the safety and feasibility of this method are conducted on minimally invasive surgery; (2) Methods: This study is a retrospective analysis of a retrospective collected database of 76 consecutive patients with cervical cancers, who were operated laparoscopically (50%), or laparotomy (50%). Sentinel nodes were defined as the ICG-positive pelvic nodes in the first and second echelons. False negative cases were defined as positive non-sentinel lymph nodes despite successful sentinel mapping or failed mapping bilaterally by per-patient assessment or unilaterally by pelvic sidewall assessment; (3) Results: Regardless of the approach (open or laparoscopic), the SLN technique achieved a total sensitivity, specificity, and negative predictive value (NPV) of 94.7%, 98.6%, and 94.7%, respectively in the entire sample. The bilateral detection rate was as high as 93.4% with identical results in both approaches. The sensitivity and NPV for SNL in open surgery was found to be similar to minimal access surgery; (4) Conclusions: ICG and SPY-PHI technique is a reliable tool to detect sentinel lymph nodes in cervical cancer during laparotomy.

【 授权许可】

Unknown