Precision Surgical Technique Enables Lymph Node Detection and Removal in Endometrial Cancer

The incidence of endometrial cancer, which is primarily known to spread through lymph nodes, has been rising significantly. Traditionally, extensive lymph node dissection is performed to confirm and remove metastases; however, this method can result in complications such as lower limb lymphedema. To tackle these challenges, various studies have been undertaken. Researchers have now shown that it is possible to detect and accurately remove metastatic lymph nodes during endometrial cancer surgery using a fluorescent contrast agent along with a laparoscopic fluorescence imaging system.

The research team at Korea University Guro Hospital (Seoul, South Korea) created an animal model with lymph node metastasis from uterine cancer and compared the targeting capabilities of two fluorescent contrast agents: indocyanine green (ICG) and neo-mannosyl human serum albumin combined with indocyanine green (MSA-ICG). Through detailed analysis, it was determined that MSA-ICG significantly enhanced CD206 (fluorescent signal) expression in metastatic lymph node tumors. Importantly, while the conventional ICG could not differentiate between metastatic and normal lymph nodes, the MSA-ICG notably increased the fluorescent signal in metastatic lymph nodes, facilitating their distinction from normal lymph nodes during surgery.

Image: The precision surgery technique can prevent complications associated with extensive lymph node dissection (Photo courtesy of 123RF)

Based on the findings published in the latest edition of the esteemed SCIE journal, International Journal of Surgery, the researchers propose that utilizing MSA-ICG in surgery can enable real-time detection and precise removal of metastatic lymph nodes. This accurate surgical technique can help prevent complications related to extensive lymph node dissection and improve patient survival by precisely excising only the cancerous tissue.

“This study demonstrates that the image-guided surgery using MSA-ICG is useful for real-time detection and precise removal of metastatic lymph nodes in endometrial cancer,” said Professor Hyun-Woong Cho of the Gynecologic Cancer Center at Korea University Guro Hospital. “As endometrial cancer is continuously increasing, we hope that this image-guided surgery using MSA-ICG will reduce complications and improve survival rates for endometrial cancer patients.”