Currie AC, et al. – Researchers carried out this work to assess the feasibility of fluorescence detection of sentinel lymph nodes (SLN) with indocyanine green (ICG) for lymphatic mapping in T1/T2 clinically staged colonic malignancy. As per observations, ICG mapping with near-infrared (NIR) fluorescence allowed mesenteric detection of SLNs in aforementioned condition

Methods

• For this study, consecutive patients with clinical T1/T2 stage colon cancer underwent endoscopic peritumoral submucosal injection of indocyanine green (ICG) for fluorescence detection of SLN using a NIR camera.
• Laparoscopic complete mesocolic excision surgery was performed on all the patients.
• The study endpoints included detection rate and sensitivity of the NIR-ICG technique.

Results

• This study included 30 patients (mean age = 68 years [range = 38-80], mean BMI = 26.2 (IQR = 24.7-28.6).
• In 27/30 patients, researchers detected mesocolic sentinel nodes (median= 3/patient) by fluorescence within the standard resection field.
• Overall, ten patients indicated lymph node metastases, with failed SLN procedure in 1/10.
• Of the 27 patients with completed SLN mapping, 9 patients indicated histologically positive lymph nodes containing malignancy.
• Positive SLNs with 6 false negatives were observed in 3/9.
• Larger than 35mm tumours were observed in five of the false negative patients with four also being T3/T4.