# FIRES & SENTOR (sentinel node mapping)

Source: https://onco.cc/trials/fires-sentor/  
OnCo record `fires-sentor` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Mapping and removing only the first draining lymph nodes finds spread as reliably as removing all of them, with far less lymphoedema.

## Summary

FIRES and SENTOR, led by trial NCT01673022 and run academically at Indiana University and the University of Toronto, showed that mapping and removing only the first draining lymph nodes with indocyanine green finds spread in endometrial cancer as reliably as removing all of them, with far less lymphoedema. FIRES, published in Lancet Oncology in 2017 with 385 patients, reported sensitivity of 97.2 percent and a negative predictive value of 99.6 percent, and SENTOR, published in JAMA Surgery in 2021 with 156 high-grade patients, reported sensitivity of 96 percent and a negative predictive value of 99 percent. Sentinel node biopsy is now standard in apparent early-stage disease under NCCN and ESGO guidance, and whether it changes survival rather than only staging is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT01673022
- Phase: observational
- Setting: Endometrial cancer staging: indocyanine-green sentinel lymph node mapping compared against full lymphadenectomy
- Sponsor: Academic (Indiana University; University of Toronto)
- Result: Sensitivity 97%, NPV 99.6% (FIRES).
- Outcomes: FIRES: sensitivity of sentinel-node mapping for nodal metastasis: ICG sentinel-node mapping vs complete lymphadenectomy 97.2%; SENTOR: sensitivity of the sentinel-node algorithm in intermediate/high-grade endometrial cancer: ICG sentinel-node biopsy vs lymphadenectomy 96%
- Replication: Two independent prospective cohorts (USA and Canada) with matching accuracy, the latter in high-grade histologies; supported by the SHREC and Italian multicentre series and now standard in NCCN/ESGO guidance.

## Sources

- ClinicalTrials.gov NCT01673022: https://clinicaltrials.gov/study/NCT01673022
- FIRES, Lancet Oncology 2017: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30068-2/fulltext

## Connected records

- cancers: [Endometrial cancer](https://onco.cc/cancers/endometrial/), [Endometrial cancer with no specific molecular profile](https://onco.cc/cancers/endometrial-nsmp/), [POLE-ultramutated endometrial cancer](https://onco.cc/cancers/endometrial-pole-ultramutated/)
- technologies: [Optical & fluorescence imaging](https://onco.cc/technologies/optical-imaging/), [Robotic & minimally invasive surgery](https://onco.cc/technologies/robotic-surgery/), [Sentinel lymph node biopsy](https://onco.cc/technologies/sentinel-node/)
- roadmaps: [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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