Real-Time Fluorescent Sentinel Lymph Node Mapping with Indocyanine Green in Women with Previous Conization Undergoing Laparoscopic Surgery for Early Invasive Cervical Cancer: Comparison with Radiotracer ± Blue Dye

被引：20

作者：

Buda, Alessandro ^{[1
]}

Papadia, Andrea ^{[2
]}

Di Martino, Giampaolo ^{[1
]}

Imboden, Sara ^{[2
]}

Bussi, Beatrice ^{[1
]}

Guerra, Luca ^{[3
]}

De Ponti, Elena ^{[4
]}

Reato, Claudio ^{[1
]}

Gasparri, Maria Luisa ^{[2
]}

Crivellaro, Cinzia ^{[3
,5
]}

Mueller, Michael ^{[2
]}

机构：

[1] Univ Milano Bicocca, San Gerardo Hosp, ASST Monza, Gynecol Oncol Unit, Monza, Italy

[2] Univ Milano Bicocca, Dept Obstet & Gynecol, San Gerardo Hosp, ASST Monza, Monza, Italy

[3] Univ Bern, Dept Nucl Med, Bern, Switzerland

[4] ASST Monza, San Gerardo Hosp, Dept Med Phys, Monza, Italy

[5] Univ Milano Bicocca, Tecnomed Fdn, Monza, Italy

来源：

JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY | 2018年 / 25卷 / 03期

关键词：

Cervical cancer; Fluorescent real-time mapping; Sentinel lymph node; Radiocolloid; Blue dye; Indocyanine green; SPARING RADICAL TRACHELECTOMY; ENDOMETRIAL CANCER; HYSTERECTOMY; BIOPSY; STANDARDIZATION; LYMPHADENECTOMY; CARCINOMA; CARE;

D O I：

10.1016/j.jmig.2017.10.002

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Study Objective: To evaluate the added value of the fluorescence dye indocyanine green (ICG) for sentinel lymph node (SLN) mapping in women with cervical cancer who had undergone previous conization (stage 1A-1B1) by comparing ICG versus Tc99(m) radiotracer + blue dye (BD). Design: Retrospective study (Canadian Task Force classification II-2). Setting: Two European academic medical centers, San Gerardo Hospital, Italy and University of Berne, Switzerland. Patients: Sixty-five women with early stage (IA-IB1) cervical cancer who had undergone previous conization and who underwent SLN mapping with Tc99(m) +/- BD (n = 23) or ICG (n = 42) followed by pelvic lymphadenectomy and fertility-sparing surgery or hysterectomy were included in this analysis. Intervention: Overall detection rate and bilateral SLN mapping rates of ICG were compared with those obtained using the standard Tc99(m) radiocolloid and BD. Measurement and Main Results: Overall, 220 SLNs were detected. The median number of SLNs per patient in the Tc99(m) +/- BD group was 2 (range, 1-5) and in the ICG group, 3 (range, 2-15). The detection rate of SLNs was 95.7% in Tc99(m) +/- BD group and 100% in the ICG group (p=.354). The women injected with ICG had a higher rate of bilateral mapping of the SLNs as compared with the Tc99(m) +/- BD group (95.2% vs 69.6%, p=.016%). Only 12% of the patients (8/65) presented metastatic nodes, 2 in the Tc99(m) +/- BD group and 6 in the ICG group. Conclusion: In early-stage cervical cancer patients conization had no significant impact on the SLN detection rate using both techniques (ICG and radiotracer +/- BD). In this scenario a higher bilateral mapping rate was confirmed using the fluorescent dye ICG rather than the standard techniques. (C) 2017 AAGL. All rights reserved.

引用

页码：455 / 460

页数：6