Endometrial cancer: green dye improves SLN mapping

  • Rozenholc A & al.
  • Gynecol Oncol
  • 19 Mar 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In women with endometrial cancer, use of indocyanine green dye instead results in a 26.5% increase in sentinel lymph node (SLN) detection rates per hemipelvis vs methylene blue dye.

Why this matters

  • Indocyanine green may become the new standard in SLN mapping.

Study design

  • Parallel, randomized controlled superiority trial of 132 patients who underwent SLN mapping after the injection of blue dye on one side of the cervix and ICG on the other side.
  • 67 patients were randomly assigned to blue dye on the left (green dye on the right) and 65 patients to blue dye on the right (green dye on the left).
  • Funding: None disclosed.

Key results

  • Detection of ≥1 SLN was higher on the side injected with green dye vs blue dye (90.9% vs 64.4%; P<.0001 style="list-style-type:circle;">
  • Similar SLN detection rates were observed whether the surgical approach was robotic (89.1% vs 65.2%) or laparoscopic (91.9% vs 63.9%).
  • No difference was observed in the duration of the SLN procedure (median, 10 minutes per hemipelvis) and number of SLNs (mean, 1.2 per hemipelvis), according to the dye used.
  • 3% of patients had crossover of dye to the contralateral hemipelvis.
  • Limitations

    • Sensitivity, negative predictive value were not evaluated.

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