Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer.

Background: The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC).

Methods: This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study.

Results: The two groups were homogeneous for age ( = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages ( = 0.41 for EC; = 0.17 for CC), median estimated blood loss ( = 0.76), median operative time ( = 0.59), and perioperative complications ( = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher ( = 0.005) in the ICG group ( = 18) compared with controls ( = 16).

Conclusions: The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.