Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer

The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC). This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study. The two groups were homogeneous for age ( = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages ( = 0.41 for EC; = 0.17 for CC), median estimated blood loss ( = 0.76), median operative time ( = 0.59), and perioperative complications ( = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher ( = 0.005) in the ICG group ( = 18) compared with controls ( = 16). The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.