The fluorescence imaging for laparoscopic and laparotomic endometrial sentinel lymph node biopsy (FILLES) trial: Siriraj gynecologic sentinel node of endometrial cancer (SiGN‐En) study

Background and Objectives The objective of this study is to establish the detection rate of sentinel lymph node (SLN) biopsies and to determine the sensitivity and false‐negative rate of SLN biopsies compared with those of systematic pelvic and para‐aortic lymphadenectomies in endometrial cancer. Me...

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Published in:Journal of surgical oncology 2024-02, Vol.129 (2), p.403-409
Main Authors: Khemworapong, Khemanat, Jaishuen, Atthapon, Srichaikul, Pisutt, Inthasorn, Perapong, Viriyapak, Boonlert, Achariyapota, Vuthinun, Jareemit, Nida, Warnnissorn, Malee, Hanamornroongruang, Suchanan, Sukmee, Jumnanja
Format: Article
Language:English
Subjects:
Biopsy
Endometrial cancer
endometrial carcinoma
lymphadenectomy
Lymphatic system
sentinel lymph node
ultrastaging
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Summary:Background and Objectives The objective of this study is to establish the detection rate of sentinel lymph node (SLN) biopsies and to determine the sensitivity and false‐negative rate of SLN biopsies compared with those of systematic pelvic and para‐aortic lymphadenectomies in endometrial cancer. Methods This prospective cohort study enrolled patients with endometrial cancer who were scheduled for surgical staging. Patients with a history of chemotherapy or radiotherapy, an abnormal liver function test, or an allergy to indocyanine green (ICG) were excluded. All patients underwent surgical staging with an ICG injection at the cervix. SLNs were identified by a near‐infrared fluorescent camera. All SLNs were sent to a pathologist for ultrastaging. Results From November 2019 to June 2023, 142 patients underwent SLN mapping and surgical staging. SLNs were not detected bilaterally in 8 patients. The detection rate of the SLN biopsies in this study was 91.2%. Thus, the accuracy of the SLN biopsies was 97.6%. The sensitivity for finding metastatic SLNs was 84.2%, with a negative predictive value of 97.22%. Conclusions A SLN biopsy in endometrial cancer has a high detection rate and high accuracy. However, surgical expertise and a learning curve are required.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.27486