A Prospective Cohort Study Comparing Colorimetric and Fluorescent Imaging for Sentinel Lymph Node Mapping in Endometrial Cancer
Background This prospective cohort study aimed to assess sentinel lymph node (SLN) mapping using isosulfan blue (ISB) compared with ISB plus indocyanine green (ICG) and near-infrared imaging (NIR) for patients with endometrial cancer. Methods In this study, 200 patients with endometrial cancer under...
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| Veröffentlicht in: | Annals of surgical oncology 2017-07, Vol.24 (7), p.1972-1979 |
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| container_title | Annals of surgical oncology |
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| creator | Holloway, Robert W. Ahmad, Sarfraz Kendrick, James E. Bigsby, Glenn E. Brudie, Lorna A. Ghurani, Giselle B. Stavitzski, Nicole M. Gise, Jasmine L. Ingersoll, Susan B. Pepe, Julie W. |
| description | Background
This prospective cohort study aimed to assess sentinel lymph node (SLN) mapping using isosulfan blue (ISB) compared with ISB plus indocyanine green (ICG) and near-infrared imaging (NIR) for patients with endometrial cancer.
Methods
In this study, 200 patients with endometrial cancer underwent SLN assessments and were randomized to ISB + ICG (
n
= 180) or ISB alone (
n
= 20). Blue dye determinations were recorded for all 200 cases followed by NIR imaging of ICG for 180 randomized subjects. All the patients underwent robotically assisted hysterectomy with pelvic ± aortic lymphadenectomy.
Results
The mean age of the patients was 64.5 ± 8.4 years, and the mean body mass index (BMI) was 33 ± 7.6 kg/m
2
. The histologies were endometrioid G1 (43%), G2 (30%), G3 (7%), and type 2 (20%). The mean time from dye injection to initiation of mapping was 13.4 ± 6.2 min, and the time to removal of SLN was 17.4 ± 11.2 min. Detection of SLN for the 20 ISB control cases did not differ from that for the 180 ISB + ICG cases (
p
> 0.05). The rates of SLN detection for ISB + ICG/NIR (
n
= 180) versus ISB (
n
= 200) were as follows: bilateral (83.9 vs. 40%), unilateral (12.2 vs. 36%), and none (3.9 vs. 24%) (
p
|
| doi_str_mv | 10.1245/s10434-017-5825-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1875142316</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1875142316</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-bdba367c5b4a5190931fb5f52ff8e942caa9a639456357a6594b0b1470506c863</originalsourceid><addsrcrecordid>eNp1kc1O3DAUha2KqkwpD8AGWWLDJq3_7SxHo4EiDW0lytpyHGcmKLGDnSDNqq-O06EIIXXl6-vP516dA8AZRl8xYfxbwohRViAsC64IL-gHsMA8d5hQ-CjXSKiiJIIfg88pPaAMUsQ_gWOiclNKuQB_lvBXDGlwdmyfHFyFXYgjvBunep8v_WBi67e56kJsezfG1kLja3jVTSG6ZJ0f4U1vtjPUhAjvcqP1roObfT_s4I9QO3hrhmF-bz1c-zr8VTEdXBlvXfwCPjamS-705TwB91fr36vvxebn9c1quSkslWQsqroyVEjLK2Y4LlFJcVPxhpOmUa5kxBpTGkFLxgXl0ghesgpVmEnEkbBK0BNwedAdYnicXBp13-b1u854F6aksZIcM0LxjF68Qx_CFH3eTufJVCHJFc0UPlA225eia_SQHTJxrzHSczr6kI7Opus5HT3_OX9Rnqre1a8__sWRAXIA0jD77uKb0f9VfQZ0C5o5</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1903807583</pqid></control><display><type>article</type><title>A Prospective Cohort Study Comparing Colorimetric and Fluorescent Imaging for Sentinel Lymph Node Mapping in Endometrial Cancer</title><source>MEDLINE</source><source>Springer Online Journals</source><creator>Holloway, Robert W. ; Ahmad, Sarfraz ; Kendrick, James E. ; Bigsby, Glenn E. ; Brudie, Lorna A. ; Ghurani, Giselle B. ; Stavitzski, Nicole M. ; Gise, Jasmine L. ; Ingersoll, Susan B. ; Pepe, Julie W.</creator><creatorcontrib>Holloway, Robert W. ; Ahmad, Sarfraz ; Kendrick, James E. ; Bigsby, Glenn E. ; Brudie, Lorna A. ; Ghurani, Giselle B. ; Stavitzski, Nicole M. ; Gise, Jasmine L. ; Ingersoll, Susan B. ; Pepe, Julie W.</creatorcontrib><description>Background
This prospective cohort study aimed to assess sentinel lymph node (SLN) mapping using isosulfan blue (ISB) compared with ISB plus indocyanine green (ICG) and near-infrared imaging (NIR) for patients with endometrial cancer.
Methods
In this study, 200 patients with endometrial cancer underwent SLN assessments and were randomized to ISB + ICG (
n
= 180) or ISB alone (
n
= 20). Blue dye determinations were recorded for all 200 cases followed by NIR imaging of ICG for 180 randomized subjects. All the patients underwent robotically assisted hysterectomy with pelvic ± aortic lymphadenectomy.
Results
The mean age of the patients was 64.5 ± 8.4 years, and the mean body mass index (BMI) was 33 ± 7.6 kg/m
2
. The histologies were endometrioid G1 (43%), G2 (30%), G3 (7%), and type 2 (20%). The mean time from dye injection to initiation of mapping was 13.4 ± 6.2 min, and the time to removal of SLN was 17.4 ± 11.2 min. Detection of SLN for the 20 ISB control cases did not differ from that for the 180 ISB + ICG cases (
p
> 0.05). The rates of SLN detection for ISB + ICG/NIR (
n
= 180) versus ISB (
n
= 200) were as follows: bilateral (83.9 vs. 40%), unilateral (12.2 vs. 36%), and none (3.9 vs. 24%) (
p
< 0.001). The median SLN per case was 2 (range 0–4). Positive SLNs were found in 21.1% (
n
= 38) of the ISB + ICG cases compared with 13.5% (
n
= 27) of the ISB cases (
p
= 0.056). The false-negative rate for SLN biopsy was 2.5% (95% confidence interval, 0.1–14.7%). In 61% (25/41) of the node-positive cases, SLN was the only positive lymph node (LN). Isolated tumor cells were found in 39.5% (15/38) of the SLN metastasis cases compared with 26.7% (4/15) of the non-SLN metastasis cases (
p
= 0.528).
Conclusions
In this prospective study, ISB + ICG and NIR detected more SLNs and more LN metastases than ISB alone. Assessment of SLN with ICG + ISB/NIR imaging had excellent sensitivity for detection of metastasis and no safety issues.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-017-5825-3</identifier><identifier>PMID: 28265777</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adenocarcinoma, Clear Cell - diagnostic imaging ; Adenocarcinoma, Clear Cell - pathology ; Adenocarcinoma, Clear Cell - surgery ; Aged ; Aorta ; Biopsy ; Body mass ; Body mass index ; Cancer ; Carcinoma, Papillary - diagnostic imaging ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Cohort analysis ; Colorimetry ; Colorimetry - methods ; Coloring Agents ; Cystadenocarcinoma, Serous - diagnostic imaging ; Cystadenocarcinoma, Serous - pathology ; Cystadenocarcinoma, Serous - surgery ; Dyes ; Endometrial cancer ; Endometrial Neoplasms - diagnostic imaging ; Endometrial Neoplasms - pathology ; Endometrial Neoplasms - surgery ; Endometrium ; Female ; Fluorescence ; Follow-Up Studies ; Gynecologic Oncology ; Health risk assessment ; Humans ; Hysterectomy ; I.R. radiation ; Indocyanine Green ; Lymph ; Lymph Nodes ; Lymphatic system ; Male ; Mapping ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Molecular Imaging - methods ; Oncology ; Pelvis ; Prognosis ; Prospective Studies ; Sentinel Lymph Node - diagnostic imaging ; Sentinel Lymph Node - pathology ; Sentinel Lymph Node - surgery ; Sentinel Lymph Node Biopsy ; Surgery ; Surgical Oncology ; Tumor cells</subject><ispartof>Annals of surgical oncology, 2017-07, Vol.24 (7), p.1972-1979</ispartof><rights>Society of Surgical Oncology 2017</rights><rights>Annals of Surgical Oncology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-bdba367c5b4a5190931fb5f52ff8e942caa9a639456357a6594b0b1470506c863</citedby><cites>FETCH-LOGICAL-c372t-bdba367c5b4a5190931fb5f52ff8e942caa9a639456357a6594b0b1470506c863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-017-5825-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-017-5825-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28265777$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holloway, Robert W.</creatorcontrib><creatorcontrib>Ahmad, Sarfraz</creatorcontrib><creatorcontrib>Kendrick, James E.</creatorcontrib><creatorcontrib>Bigsby, Glenn E.</creatorcontrib><creatorcontrib>Brudie, Lorna A.</creatorcontrib><creatorcontrib>Ghurani, Giselle B.</creatorcontrib><creatorcontrib>Stavitzski, Nicole M.</creatorcontrib><creatorcontrib>Gise, Jasmine L.</creatorcontrib><creatorcontrib>Ingersoll, Susan B.</creatorcontrib><creatorcontrib>Pepe, Julie W.</creatorcontrib><title>A Prospective Cohort Study Comparing Colorimetric and Fluorescent Imaging for Sentinel Lymph Node Mapping in Endometrial Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
This prospective cohort study aimed to assess sentinel lymph node (SLN) mapping using isosulfan blue (ISB) compared with ISB plus indocyanine green (ICG) and near-infrared imaging (NIR) for patients with endometrial cancer.
Methods
In this study, 200 patients with endometrial cancer underwent SLN assessments and were randomized to ISB + ICG (
n
= 180) or ISB alone (
n
= 20). Blue dye determinations were recorded for all 200 cases followed by NIR imaging of ICG for 180 randomized subjects. All the patients underwent robotically assisted hysterectomy with pelvic ± aortic lymphadenectomy.
Results
The mean age of the patients was 64.5 ± 8.4 years, and the mean body mass index (BMI) was 33 ± 7.6 kg/m
2
. The histologies were endometrioid G1 (43%), G2 (30%), G3 (7%), and type 2 (20%). The mean time from dye injection to initiation of mapping was 13.4 ± 6.2 min, and the time to removal of SLN was 17.4 ± 11.2 min. Detection of SLN for the 20 ISB control cases did not differ from that for the 180 ISB + ICG cases (
p
> 0.05). The rates of SLN detection for ISB + ICG/NIR (
n
= 180) versus ISB (
n
= 200) were as follows: bilateral (83.9 vs. 40%), unilateral (12.2 vs. 36%), and none (3.9 vs. 24%) (
p
< 0.001). The median SLN per case was 2 (range 0–4). Positive SLNs were found in 21.1% (
n
= 38) of the ISB + ICG cases compared with 13.5% (
n
= 27) of the ISB cases (
p
= 0.056). The false-negative rate for SLN biopsy was 2.5% (95% confidence interval, 0.1–14.7%). In 61% (25/41) of the node-positive cases, SLN was the only positive lymph node (LN). Isolated tumor cells were found in 39.5% (15/38) of the SLN metastasis cases compared with 26.7% (4/15) of the non-SLN metastasis cases (
p
= 0.528).
Conclusions
In this prospective study, ISB + ICG and NIR detected more SLNs and more LN metastases than ISB alone. Assessment of SLN with ICG + ISB/NIR imaging had excellent sensitivity for detection of metastasis and no safety issues.</description><subject>Adenocarcinoma, Clear Cell - diagnostic imaging</subject><subject>Adenocarcinoma, Clear Cell - pathology</subject><subject>Adenocarcinoma, Clear Cell - surgery</subject><subject>Aged</subject><subject>Aorta</subject><subject>Biopsy</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Carcinoma, Papillary - diagnostic imaging</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Cohort analysis</subject><subject>Colorimetry</subject><subject>Colorimetry - methods</subject><subject>Coloring Agents</subject><subject>Cystadenocarcinoma, Serous - diagnostic imaging</subject><subject>Cystadenocarcinoma, Serous - pathology</subject><subject>Cystadenocarcinoma, Serous - surgery</subject><subject>Dyes</subject><subject>Endometrial cancer</subject><subject>Endometrial Neoplasms - diagnostic imaging</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Endometrium</subject><subject>Female</subject><subject>Fluorescence</subject><subject>Follow-Up Studies</subject><subject>Gynecologic Oncology</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Hysterectomy</subject><subject>I.R. radiation</subject><subject>Indocyanine Green</subject><subject>Lymph</subject><subject>Lymph Nodes</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Mapping</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Molecular Imaging - methods</subject><subject>Oncology</subject><subject>Pelvis</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Sentinel Lymph Node - diagnostic imaging</subject><subject>Sentinel Lymph Node - pathology</subject><subject>Sentinel Lymph Node - surgery</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Tumor cells</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc1O3DAUha2KqkwpD8AGWWLDJq3_7SxHo4EiDW0lytpyHGcmKLGDnSDNqq-O06EIIXXl6-vP516dA8AZRl8xYfxbwohRViAsC64IL-gHsMA8d5hQ-CjXSKiiJIIfg88pPaAMUsQ_gWOiclNKuQB_lvBXDGlwdmyfHFyFXYgjvBunep8v_WBi67e56kJsezfG1kLja3jVTSG6ZJ0f4U1vtjPUhAjvcqP1roObfT_s4I9QO3hrhmF-bz1c-zr8VTEdXBlvXfwCPjamS-705TwB91fr36vvxebn9c1quSkslWQsqroyVEjLK2Y4LlFJcVPxhpOmUa5kxBpTGkFLxgXl0ghesgpVmEnEkbBK0BNwedAdYnicXBp13-b1u854F6aksZIcM0LxjF68Qx_CFH3eTufJVCHJFc0UPlA225eia_SQHTJxrzHSczr6kI7Opus5HT3_OX9Rnqre1a8__sWRAXIA0jD77uKb0f9VfQZ0C5o5</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Holloway, Robert W.</creator><creator>Ahmad, Sarfraz</creator><creator>Kendrick, James E.</creator><creator>Bigsby, Glenn E.</creator><creator>Brudie, Lorna A.</creator><creator>Ghurani, Giselle B.</creator><creator>Stavitzski, Nicole M.</creator><creator>Gise, Jasmine L.</creator><creator>Ingersoll, Susan B.</creator><creator>Pepe, Julie W.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170701</creationdate><title>A Prospective Cohort Study Comparing Colorimetric and Fluorescent Imaging for Sentinel Lymph Node Mapping in Endometrial Cancer</title><author>Holloway, Robert W. ; Ahmad, Sarfraz ; Kendrick, James E. ; Bigsby, Glenn E. ; Brudie, Lorna A. ; Ghurani, Giselle B. ; Stavitzski, Nicole M. ; Gise, Jasmine L. ; Ingersoll, Susan B. ; Pepe, Julie W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-bdba367c5b4a5190931fb5f52ff8e942caa9a639456357a6594b0b1470506c863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenocarcinoma, Clear Cell - diagnostic imaging</topic><topic>Adenocarcinoma, Clear Cell - pathology</topic><topic>Adenocarcinoma, Clear Cell - surgery</topic><topic>Aged</topic><topic>Aorta</topic><topic>Biopsy</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Carcinoma, Papillary - diagnostic imaging</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Cohort analysis</topic><topic>Colorimetry</topic><topic>Colorimetry - methods</topic><topic>Coloring Agents</topic><topic>Cystadenocarcinoma, Serous - diagnostic imaging</topic><topic>Cystadenocarcinoma, Serous - pathology</topic><topic>Cystadenocarcinoma, Serous - surgery</topic><topic>Dyes</topic><topic>Endometrial cancer</topic><topic>Endometrial Neoplasms - diagnostic imaging</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Endometrium</topic><topic>Female</topic><topic>Fluorescence</topic><topic>Follow-Up Studies</topic><topic>Gynecologic Oncology</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Hysterectomy</topic><topic>I.R. radiation</topic><topic>Indocyanine Green</topic><topic>Lymph</topic><topic>Lymph Nodes</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Mapping</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Molecular Imaging - methods</topic><topic>Oncology</topic><topic>Pelvis</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Sentinel Lymph Node - diagnostic imaging</topic><topic>Sentinel Lymph Node - pathology</topic><topic>Sentinel Lymph Node - surgery</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Tumor cells</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holloway, Robert W.</creatorcontrib><creatorcontrib>Ahmad, Sarfraz</creatorcontrib><creatorcontrib>Kendrick, James E.</creatorcontrib><creatorcontrib>Bigsby, Glenn E.</creatorcontrib><creatorcontrib>Brudie, Lorna A.</creatorcontrib><creatorcontrib>Ghurani, Giselle B.</creatorcontrib><creatorcontrib>Stavitzski, Nicole M.</creatorcontrib><creatorcontrib>Gise, Jasmine L.</creatorcontrib><creatorcontrib>Ingersoll, Susan B.</creatorcontrib><creatorcontrib>Pepe, Julie W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holloway, Robert W.</au><au>Ahmad, Sarfraz</au><au>Kendrick, James E.</au><au>Bigsby, Glenn E.</au><au>Brudie, Lorna A.</au><au>Ghurani, Giselle B.</au><au>Stavitzski, Nicole M.</au><au>Gise, Jasmine L.</au><au>Ingersoll, Susan B.</au><au>Pepe, Julie W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Prospective Cohort Study Comparing Colorimetric and Fluorescent Imaging for Sentinel Lymph Node Mapping in Endometrial Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>24</volume><issue>7</issue><spage>1972</spage><epage>1979</epage><pages>1972-1979</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
This prospective cohort study aimed to assess sentinel lymph node (SLN) mapping using isosulfan blue (ISB) compared with ISB plus indocyanine green (ICG) and near-infrared imaging (NIR) for patients with endometrial cancer.
Methods
In this study, 200 patients with endometrial cancer underwent SLN assessments and were randomized to ISB + ICG (
n
= 180) or ISB alone (
n
= 20). Blue dye determinations were recorded for all 200 cases followed by NIR imaging of ICG for 180 randomized subjects. All the patients underwent robotically assisted hysterectomy with pelvic ± aortic lymphadenectomy.
Results
The mean age of the patients was 64.5 ± 8.4 years, and the mean body mass index (BMI) was 33 ± 7.6 kg/m
2
. The histologies were endometrioid G1 (43%), G2 (30%), G3 (7%), and type 2 (20%). The mean time from dye injection to initiation of mapping was 13.4 ± 6.2 min, and the time to removal of SLN was 17.4 ± 11.2 min. Detection of SLN for the 20 ISB control cases did not differ from that for the 180 ISB + ICG cases (
p
> 0.05). The rates of SLN detection for ISB + ICG/NIR (
n
= 180) versus ISB (
n
= 200) were as follows: bilateral (83.9 vs. 40%), unilateral (12.2 vs. 36%), and none (3.9 vs. 24%) (
p
< 0.001). The median SLN per case was 2 (range 0–4). Positive SLNs were found in 21.1% (
n
= 38) of the ISB + ICG cases compared with 13.5% (
n
= 27) of the ISB cases (
p
= 0.056). The false-negative rate for SLN biopsy was 2.5% (95% confidence interval, 0.1–14.7%). In 61% (25/41) of the node-positive cases, SLN was the only positive lymph node (LN). Isolated tumor cells were found in 39.5% (15/38) of the SLN metastasis cases compared with 26.7% (4/15) of the non-SLN metastasis cases (
p
= 0.528).
Conclusions
In this prospective study, ISB + ICG and NIR detected more SLNs and more LN metastases than ISB alone. Assessment of SLN with ICG + ISB/NIR imaging had excellent sensitivity for detection of metastasis and no safety issues.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28265777</pmid><doi>10.1245/s10434-017-5825-3</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2017-07, Vol.24 (7), p.1972-1979 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1875142316 |
| source | MEDLINE; Springer Online Journals |
| subjects | Adenocarcinoma, Clear Cell - diagnostic imaging Adenocarcinoma, Clear Cell - pathology Adenocarcinoma, Clear Cell - surgery Aged Aorta Biopsy Body mass Body mass index Cancer Carcinoma, Papillary - diagnostic imaging Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Cohort analysis Colorimetry Colorimetry - methods Coloring Agents Cystadenocarcinoma, Serous - diagnostic imaging Cystadenocarcinoma, Serous - pathology Cystadenocarcinoma, Serous - surgery Dyes Endometrial cancer Endometrial Neoplasms - diagnostic imaging Endometrial Neoplasms - pathology Endometrial Neoplasms - surgery Endometrium Female Fluorescence Follow-Up Studies Gynecologic Oncology Health risk assessment Humans Hysterectomy I.R. radiation Indocyanine Green Lymph Lymph Nodes Lymphatic system Male Mapping Medicine Medicine & Public Health Metastases Metastasis Molecular Imaging - methods Oncology Pelvis Prognosis Prospective Studies Sentinel Lymph Node - diagnostic imaging Sentinel Lymph Node - pathology Sentinel Lymph Node - surgery Sentinel Lymph Node Biopsy Surgery Surgical Oncology Tumor cells |
| title | A Prospective Cohort Study Comparing Colorimetric and Fluorescent Imaging for Sentinel Lymph Node Mapping in Endometrial Cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T11%3A55%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Prospective%20Cohort%20Study%20Comparing%20Colorimetric%20and%20Fluorescent%20Imaging%20for%20Sentinel%20Lymph%20Node%20Mapping%20in%20Endometrial%20Cancer&rft.jtitle=Annals%20of%20surgical%20oncology&rft.au=Holloway,%20Robert%20W.&rft.date=2017-07-01&rft.volume=24&rft.issue=7&rft.spage=1972&rft.epage=1979&rft.pages=1972-1979&rft.issn=1068-9265&rft.eissn=1534-4681&rft_id=info:doi/10.1245/s10434-017-5825-3&rft_dat=%3Cproquest_cross%3E1875142316%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1903807583&rft_id=info:pmid/28265777&rfr_iscdi=true |