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Sentinel Node Mapping in Cervical and Endometrial Cancer: Indocyanine Green Versus Other Conventional Dyes—A Meta-Analysis

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Historically, blue dyes, 99Tc or a combination of the two tracers have been used for sentinel lymph node (SLN) mapping in cervical and endometrial cancer patients. Indocyanine green (ICG), as a tracer, has been recently introduced in this setting. Our goal was to assess the differences in overall and bilateral detection rates as well as in false-negative rates among the different tracers.

Methods

The electronic databases PubMed, MEDLINE, and Scopus were searched in January 2016 by searching the terms “sentinel lymph node” and “dye” and “indocyanine green,” and “cervical cancer” or “endometrial cancer.” Series comparing different tracers injected intracervically and reporting the detection rate and/or SLN false-negative rate were selected.

Results

Forty-five studies were retrieved. Six studies including 538 patients met selection criteria. Compared with blue dyes, ICG SLN mapping had higher overall (odds ratio [OR] 0.27; 95 % confidence interval [CI] 0.15–0.50; p < 0.0001) and bilateral detection rates (OR 0.27; 95 % CI 0.19–0.40; p < 0.00001). No differences were found between ICG and 99TC, although these results are based on data of a single series. No differences in overall and bilateral detection rates were found between ICG and the combination of blue dyes and 99TC. The pooled analysis of false-negative rates data showed no difference in false-negative rates between tracers.

Conclusions

In cervical and endometrial cancer, ICG SLN mapping seems to be equivalent to the combination of blue dyes and 99TC in terms of overall and bilateral detection rates. Its safety profile and ease of use may favor its employment respect to conventional tracers.

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Conflict of interest

All authors declare no conflict of interest.

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Author notes

    Authors and Affiliations

    1. Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy

      Ilary Ruscito MD, Maria Luisa Gasparri MD & Pierluigi Benedetti Panici MD

    2. Department of Gynecology, Campus Virchow Clinic, Charité Medical University, Berlin, Germany

      Ilary Ruscito MD, Elena Ioana Braicu MD, PhD & Jalid Sehouli MD, PhD

    3. Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland

      Maria Luisa Gasparri MD, Luigi Raio MD, Michael D. Mueller MD & Andrea Papadia MD, PhD

    4. Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy

      Filippo Bellati MD, PhD

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    Correspondence to Maria Luisa Gasparri MD.

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    Ilary Ruscito and Maria Luisa Gasparri have contributed equally to this work.

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    Ruscito, I., Gasparri, M.L., Braicu, E.I. et al. Sentinel Node Mapping in Cervical and Endometrial Cancer: Indocyanine Green Versus Other Conventional Dyes—A Meta-Analysis. Ann Surg Oncol 23, 3749–3756 (2016). https://doi.org/10.1245/s10434-016-5236-x

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    • DOI: https://doi.org/10.1245/s10434-016-5236-x

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