VIDEO: Indocyanine green finds more sentinel lymph nodes

The results from the FILM trial are potentially practice changing. The findings presented by Michael M. Frumovitz, MD, and his associates showed that indocyanine green is superior to isosulfan blue dye for mapping sentinel lymph nodes in patients with stage I endometrial or cervical cancer. The results also showed that using both dyes was no better than using indocyanine green alone.

Mapping sentinel lymph nodes using indocyanine green requires a near-infrared fluorescence imaging camera to detect labeled lymph nodes. This equipment is already in place at many U.S. cancer centers, and after this approach receives Food and Drug Administration approval, the necessary equipment will likely be acquired by many additional centers, which thereby will allow many more patients to have access to the benefits of this technology.

The report by Floor J. Backes, MD, addressed an important and still unresolved question in treating patients with stage I or II endometrial cancer: What is the significance of finding isolated tumor cells in sentinel lymph nodes in these patients? The retrospective findings she presented showed that the presence of isolated tumor cells had no apparent effect on recurrence-free survival, recurrence pattern, or patient response to various treatments. This suggested th at treatment decisions in these patients should depend on other high-risk uterine factors but not on whether some lymph nodes contained isolated tumor cells.

Brent Smith, MD , is a gynecologic oncologist at the Ohio State University, Columbus. He had no disclosures. Dr. Smith made these comments in a video interview.