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Mapping and removing only the first draining lymph nodes finds spread as reliably as removing all of them, with far less lymphoedema.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
95% CI 85.0-100; 385 enrolled, 340 analysed; negative predictive value 99.6% (95% CI 97.9-100)
Source95% CI 81-100; negative predictive value 99% (95% CI 96-100); false-negative rate 4%
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| FIRES: sensitivity of sentinel-node mapping for nodal metastasisprimary | ICG sentinel-node mapping vs complete lymphadenectomy | 340 | 97.2% | - | - | link |
| SENTOR: sensitivity of the sentinel-node algorithm in intermediate/high-grade endometrial cancerprimary | ICG sentinel-node biopsy vs lymphadenectomy | 156 | 96% | - | - | link |
Shares POLE-ultramutated endometrial cancer, Endometrial cancer with no specific molecular profile.
Shares POLE-ultramutated endometrial cancer, Endometrial cancer with no specific molecular profile, Endometrial cancer.
Shares POLE-ultramutated endometrial cancer, Endometrial cancer with no specific molecular profile.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Sentinel lymph node biopsy.
Shares POLE-ultramutated endometrial cancer, Endometrial cancer with no specific molecular profile, Endometrial cancer.
Shares Robotic & minimally invasive surgery, Endometrial cancer.
Shares Endometrial cancer with no specific molecular profile, Endometrial cancer.
Shares POLE-ultramutated endometrial cancer, Endometrial cancer with no specific molecular profile, Endometrial cancer.