The value of sentinel lymphnode mapping with ICG in endometrial cancer

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HYPTOHESIS: Sentinel lymph node biopsy (SLB) with Indocyanine green (ICG) mapping is a valuable tool in endometrial cancer patients for pathological staging of the disease which improves short-term and long-term outcomes. AIM: To determine the value of SLB in endometrial cancer staging and to evaluate short and long - term treatment outcomes. TASKS: 1. To determine the influence of body mass index (BMI) and uterine or uterine cervix comorbidities on the detection rate of sentinel lymph node mapped with ICG. 2. To evaluate the incidence rate of micro-metastasis and isolated tumour cells (ITC) in SLB and its coherency with local spread of the endometrial cancer. 3. To evaluate the surgeons learning curve in detecting and resecting SLB mapped with ICG. METHODS: It is a prospective interventional study that is carried out in Lithuanian University of Health Sciences Hospital, Obstetrics and gynaecology Department. Inclusion criteria: - histologically confirmed high risk endometrial carcinoma of the uterus (G 2-3), non-endometrioid carcinoma, carcinosarcoma; - clinically staged non less than stage I B (FIGO) uterine carcinoma. Exclusion criteria: - surgery is done by laparotomy. For patients undergoing surgical treatment for endometrial cancer - total laparoscopic hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy - indocyanine green dye (ICG) will be used to map sentinel lymph nodes: 1ml of ICG will be injected in 4 points of uterine cervix mucosa and stroma. During laparoscopic surgery in near-infrared light sentinel lymph nodes will be visualised and resected before proceeding with next steps of the surgery - total pelvic lymphadenectomy and hysterectomy. Sentinel lymph nodes will be examined by pathologist using ultra-staging protocol to find micro-metastasis and isolated tumour cells (ITC).