EP112/#621 Laparoscopic pelvic sentinel lymph node dissection using near infrared fluorescence with indocyanine green in carcinoma endometrium. (4th December 2022)

• Record Type: Journal Article
• Authors: Gupta, Saumya; Bhati, Priya; Rajanbabu, Anupama
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A93
• Page End: A93
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.203
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Laparoscopic pelvic SLNB using ICG, is a viable option, especially in LMICs where access to robot or its prohibitive cost are limiting factors. We looked into the feasibility, detection rate and location of sentinel nodes in laparoscopic staging for carcinoma endometrium using real time ICG fluorescence mapping of SLN. Methods: In this single institution study, 50 patients with endometrial cancer who underwent laparoscopic staging with SLNB from April 2021 to March 2022, were included. Results: Mean age was 55 years, and mean BMI- 29 kg/m2(range 21–39.5). 8(16%) patients had high risk histopathology with p53 positivity in preoperative endometrial biopsy. 8(16%) patients had >50% MI on MRI. Overall sentinel detection rate was 88% with bilateral sentinel detection rate being 86%. Most common location for first sentinel node was external iliac (46.59%), followed by obturator (26.1%), internal iliac (25%) and common iliac(2.27%). Mean number of nodes removed were 2 on either side. For the 6 patients with bilateral failed mapping, pelvic lymphadenectomy was done. One patient with unilateral sentinel detection had side specific hemipelvic lymphadenectomy. Mean duration of surgery was 82.5 min. 84% patients had Stage IA disease.7(14%) patients had stage IB disease. 1(2%) patient was Stage II. 80% patients were Low risk. 16% were high intermediate/high risk. No nodes were positive on ultrastaging. Conclusions: Laparoscopic staging with SLNB using ICG is a practicable approach for uterine limited disease on preoperative evaluation. It extends the benefits of minimally invasive surgery to these patients, while overcoming the limitations of prohibitive cost or availability of expensive equipment.