| Abstract [eng] |
Endometrial cancer is the most common malignant tumor of the female genital tract in developed countries. The success of treatment depends on accurate disease staging, with lymph node assessment being a crucial step. Although systematic lymphadenectomy provides reliable evaluation of tumor spread, it increases the risk of complications such as lymphoceles and nerve or vascular injuries, and does not improve survival in non-metastatic cases. Therefore, as sentinel lymph node biopsy gains importance, more attention is devoted to optimizing visualization methods. This study aimed to evaluate the efficacy of methylene blue, indocyanine green, and their combination for sentinel lymph node visualization. A prospective randomized study included 136 patients who underwent laparoscopic hysterectomy for non-metastatic endometrial cancer at Vilnius university hospital Santaros klinikos between 2020 and 2025. The combination of tracers achieved superior quantitative and qualitative visualization results compared to single tracers. Visualization success was significantly affected by the staining method, age, body mass index, uterine volume, previous surgeries, and enlarged lymph nodes. A prognostic model was developed to predict bilateral visualization success preoperatively. Its use in clinical practice enables individualized tracer selection, reduces complication risk, and promotes rational use of resources. |
