Publication details

Predictors for sentinel lymph node mapping failure using indocyanine green injection in apparent early stages of endometrial cancer: A single-center prospective study

Authors

BRETOVÁ Petra MINÁŘ Luboš OVESNÁ Petra WEINBERGER Vít FELSINGER Michal KOBLÍŽKOVÁ Michaela HAUSNEROVÁ Jitka JANDÁKOVÁ Eva STUPKOVÁ Tatiana

Year of publication 2025
Type Peer-reviewed scientific article
Magazine / Source INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
MU Faculty or unit

Faculty of Medicine

Citation
web https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70123
Doi https://doi.org/10.1002/ijgo.70123
Keywords biopsy; endometrial cancer; myomas; obesity; sentinel lymph node
Description Objective The current study aimed to analyze predictive factors of sentinel lymph node mapping failure in apparently early stages of endometrial cancer using intracervical indocyanine green injection.Methods A single-center prospective study was conducted between June 2019 and August 2023 at the Department of Gynecology and Obstetrics, University Hospital Brno, Czech Republic. All patients with apparently early stage (I or II according to FIGO [International Federation of Gynecology & Obstetrics] 2009) endometrial cancer, who were indicated for sentinel node biopsy were consecutively included. The injection of 4-6 mL of indocyanine green was applied superficially and deeply into cervical tissue at the 3- and 9-o'clock positions. Patients' clinical data, surgical characteristics, and histopathological information were recorded. Univariable and multivariable regression analyses were applied.Results A total of 225 patients were eligible during the study period. Considering bilateral and unilateral failed mapping together, the only statistically significant factors for risk of failure in univariable analysis were body mass index (BMI; P = 0.036), FIGO 2009 stage (P = 0.019), and the presence of a myoma (P = 0.017). Nevertheless, when the multivariable logistic regression analysis was applied, all factors became statistically insignificant except for myoma (P = 0.031). Regarding only bilateral mapping failure, in univariable analysis, BMI (P = 0.021) and FIGO 2009 stage (P = 0.046) were significant predictors of failure. Interestingly, multivariable logistic regression analysis revealed that in addition to BMI (P = 0.007), age (P = 0.004) was also an independent predictor of bilateral failure.Conclusions Higher BMI and age were statistically significant independent factors for bilateral sentinel node mapping failure in early-stage endometrial cancer.

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