1059 Surgical outcomes of indocyanine green sentinel lymph node mapping compared with systemic lymphadenectomy in the surgical staging of early endometrial cancer

Introduction/Background Systemic lymphadenectomy (SL) has traditionally been considered the standard of care for diagnosing lymph node (LN) status in patients with EC. Though the therapeutic role of LE is questionable, especially in the early-stage uterine-confirmed endometrioid type Endometrial cancer (EC), its role in surgical staging affects the choice of adjuvant treatment. Sentinel lymph node (SLN) mapping is becoming an acceptable alternative to SL for evaluating lymphatic spread in clinical stage I-II EC. Methodology A prospective cohort single-centre study included 86 patients with FIGO stage I-II endometrioid type of EC. As a part of surgical staging, including total laparoscopic hysterectomy with bilateral salpingoophorectomy, LN removal was carried out in two ways: 1) Indocyanine green (ICG) mapping for detection of pelvic SLN (n = 44, group 1); pelvic SL (n = 42, group 2). Results The time of the operation for group 1 was shorter - (53.5 ± 8.6) min than for the second - (88.8 ± 9.3) min. There were no intra- and postoperative complications in group 1. In group 2 postoperative complications were observed in 7 (16,7%) cases: lymphocysts in 2 (4.8%), lymphostasis – in 1 (2.4%), prolonged lymphorrhea 3 (7.1%) and intraoperative - lesions of the obturator nerve in 1 patients (2.4%). In 29 (70 %) patients SLN was detected on both sides, 10 (20 %) - on one side, and 3 (10 %) - not detected. In these 10% of patients, SL dissection was performed. The most common localizations of LN are the external iliac vessels and the obturator area on both sides. Positive LNs were found only in 2 (4.8%) patients. Conclusion ICG mapping SLN technique can be used more often in patients with low and intermediate risk of lymphatic metastases to improve the surgical results and reduce complications associated with SL. Disclosures None.