8602 Adopting Sentinel Lymph-Node Mapping in Early Endometrial Cancers- a Pilot Study

Abstract

<h3>Study Objective</h3> Sentinel Lymph node mapping has emerged as the new frontier in surgical staging of early endometrial cancers. Different colorimetric and radioactive tracers have been proposed. Fluorometric mapping using indocyanine green (ICG) appears to be suitable and attractive alternative to provide reliable staging. <h3>Design</h3> in this video we present the technique of SLN mapping in 2 cases followed by para-aortic Lymphadenectomy in one case with positive sentinel lymph node using ICG and near-infrared technology provided by the newer imaging systems. Together we also report the preliminary experience on the first 25 cases performed at our center since 2021. <h3>Setting</h3> After complete evaluation early well differentiated endometrial carcinomas were selected to undergo sentinel lymph node mapping. The patients were positioned in the in a dorsal lithotomy position after complete written informed consent. We adopted the Memorial Sloan Kettering Cancer Center SLN algorithm; All samples were subjected to frozen section and ultra-staging. . SLN was detected in all the cases (25/25, 100%). <h3>Patients or Participants</h3> During this period till date 25 cases have been enrolled. <h3>Interventions</h3> Laparoscopic staging surgery. <h3>Measurements and Main Results</h3> Bilateral SLN was detected in all the cases (100%). 13 (52%) patients received systematic pelvic lymphadenectomy after SLN mapping, and 1 patient underwent a para-aortic lymphadenectomy for positive pelvic lymph nodes. There were no peri-operative complications detected. <h3>Conclusion</h3> SLN mapping has been acknowledged by National Comprehensive Cancer Network as a viable option for management for selected uterine malignancies. Currently near infrared imaging technology is built in many camera systems and provides real-time imaging with ICG. Ours is an ongoing study and this is our preliminary observations, and these indicate that SLN mapping is an effective and safe procedure with high overall detection and low false negative rates.