Comparison between laparoscopic and robotic surgery for sentinel lymph node mapping in endometrial cancer using indocyanine green and near infra-red fluorescence imaging

Chaowawanit, Woraphot; Campbell, V. Star; Wilson, Emily L.; Chetty, Naven; Perrin, Lewis; Jagasia, Nisha; Barry, Sinead

doi:10.1080/01443615.2020.1789953

Cited by 8 publications

(13 citation statements)

References 14 publications

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“…This is in contrast with previous studies, which correlated the higher BMI with no or unilateral SLN mapping ( Eriksson et al, 2016 ; Tanner et al, 2015 ). Moreover, this is in contrast with a very recent study that found a higher overall detection rate using the laparoscopic approach, compared to robotic (with no difference in bilateral detection rate) ( Chaowawanit et al, 2020 ). Nevertheless, other studies reported that BMI was not a clinical characteristic which infl uenced the rate of bilateral SLN detection ( Stephens et al, 2020 ; Tortorella et al, 2019 ; Body et al, 2018 ).…”

Section: Discussioncontrasting

confidence: 99%

“…To the best of our knowledge, there is only one study which specifically compared the robotic versus the laparoscopic approach with regards to SLN detection rate with ICG ( Chaowawanit et al, 2020 ), but this was limited by the low number of patients. The primary aim of this present study was to assess whether there is a difference in bilateral detection rate of SLN in endometrial cancer treated with the laparoscopic versus the robotic approach; secondary aims were to assess variables affecting bilateral detection rates in the entire cohort and to assess survival difference in patients with no and unilateral, compared to bilateral SLN detection.…”

Section: Introductionmentioning

confidence: 99%

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Sentinel lymph node detection in endometrial cancer with indocyanine green: laparoscopic versus robotic approach.

Bizzarri

Restaino

Alletti

et al. 2021

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Background: The aims of the present study were to assess bilateral sentinel lymph node (SLN) mapping with laparoscopic versus robotic approach, to assess variables affecting bilateral detection rates and to assess survival difference in patients with no/unilateral, compared to bilateral SLN detection. Methods: This is a retrospective, single-centre, observational cohort study, including patients with endometrial cancer FIGO stage IA-IVB, treated with minimally invasive primary surgery and undergoing indocyanine green (ICG) injection to detect SLN, between January 2015 and December 2019. Results: Of the 549 included patients, 286 (52.1%) and 263 (47.9%) underwent the laparoscopic and robotic approach respectively. 387 (70.5%) patients had bilateral SLN mapping, 102 (18.6%) and 60 (10.9%) had unilateral and no mapping, respectively. Patients who underwent the robotic approach were older (median 61 versus 64 years, p=0.046) and had a higher BMI (median 26.0 versus 34.8 kg/m2, p<0.001). No difference in any SLN mapping or in SLN bilateral detection was evident between the laparoscopic or robotic approach (p=0.892 and p=0.507 respectively). Patients with bilateral SLN detection in the entire cohort were younger (p<0.001) and had a better 3-year disease-free survival (DFS) compared to patients with no/unilateral SLN mapping (77.0% versus 66.3%, respectively, p=0.036). No 3-year overall survival (OS) difference was reported (p=0.491). Conclusion: SLN mapping and bilateral SLN detection with ICG in endometrial cancer was not different in the laparoscopic and robotic approach, even though patients undergoing the robotic approach were older and more obese. Bilateral SLN detection was associated with improved 3-year DFS, but not with 3-year OS, compared to no and unilateral SLN detection.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node detection in endometrial cancer with indocyanine green: laparoscopic versus robotic approach.

Bizzarri

Restaino

Alletti

et al. 2021

Facts Views Vis ObGyn

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“…While, Chaowawanit et al summarized 76 patients with laparoscopic surgery and 33 patients with robotic approach. The result showed that laparoscopic procedure was superior than robotic in DR (97% vs. 83%, p = 0.046) and BDR (88% vs. 73%), whereas the two groups showed similar SLN detection and dissect time ( 78 ).…”

Section: The Diagnostic Accuracy Of Slnmmentioning

confidence: 95%

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

et al. 2021

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Endometrial cancer (EC) is known as a common gynecological malignancy. The incidence rate is on the increase annually. Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2; (2) myometrial invasion< 1/2; (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). However, conventional LAD shows high complication incidence and uncertain survival benefits. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic metastasis of the primary malignant tumor through the regional lymphatic drainage pathway and can indicate the involvement of lymph nodes across the drainage area. Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node mapping (SLNM) with pathologic ultra-staging. Meanwhile, SLNM did not compromise the patient’s progression-free survival (PFS) and overall survival (OS) with low operative complications. However, the application of SLNM in early-stage high-risk EC patients remains controversial. As revealed by the recent studies, SLNM may also be feasible, effective, and safe in high-risk patients. This review aims at making a systematic description of the progress made in the application of SLNM in the treatment of EC and the relevant controversies, including the application of SLNM in high-risk patients.

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“…In addition, CNSI can be observed in vivo after approximately 3-4 months [11]. In recent years, both CNSI and ICG have gained acceptance among surgeons for minimally invasive procedures, such as laparoscopy and robotic surgery [12][13][14], but they have different effects when used as intraoperative lymph node/micro lymph node tracers and for postoperative lymph node sorting.…”

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confidence: 99%

Safety and efficacy of carbon nanoparticle suspension injection and indocyanine green tracer-guided lymph node dissection during robotic distal gastrectomy in patients with gastric cancer

et al. 2021

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Background There is a lack of comparative analyses on the use of carbon nanoparticle suspension injection (CNSI) and indocyanine green (ICG) tracer technology for lymph node detection and their perioperative safety in robotic radical gastrectomy. Methods A retrospective analysis was performed on patients who underwent robotic distal gastrectomy between November 2019 and November 2020. Patients were assigned to the CNSI group, the ICG group, or the control group. The number of lymph nodes detected, number of lymph nodes detected at each station, number of micro lymph nodes detected, rate of lymph node metastasis, and inoperative and postoperative recovery were compared. Results Of the 93 patients analyzed, 34 were in the CNSI group, 27 were in the ICG group, and 32 were in the control group. The mean number of lymph nodes retrieved in the CNSI group (48.44) was higher than that in the ICG (39.19) and control (35.28) groups (P = 0.004; P < 0.001), and there was no difference between the ICG and control groups (P = 0.102). The mean number of micro lymph nodes retrieved in the CNSI group (13.24) was higher than that in the ICG (5.74) and control (5.66) groups (P < 0.001). The lymph node metastasis rates in the CNSI, ICG, and control groups were 5.03, 4.63, and 5.93%, respectively (P > 0.05). Conclusion The effect of CNSI on lymph node dissection and sorting was better than that of ICG, and CNSI improved the surgical quality and reduced lymph node staging deviation to a greater extent. CNSI was better than ICG in terms of improving the number of micro lymph nodes detected.

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Comparison between laparoscopic and robotic surgery for sentinel lymph node mapping in endometrial cancer using indocyanine green and near infra-red fluorescence imaging

Cited by 8 publications

References 14 publications

Sentinel lymph node detection in endometrial cancer with indocyanine green: laparoscopic versus robotic approach.

Sentinel lymph node detection in endometrial cancer with indocyanine green: laparoscopic versus robotic approach.

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Safety and efficacy of carbon nanoparticle suspension injection and indocyanine green tracer-guided lymph node dissection during robotic distal gastrectomy in patients with gastric cancer

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