A Comparative Analysis of Sentinel Lymph Node Sampling Utilizing Sentinel Lymphoscintigraphy Alone Versus the Combined Application of Sentinel Lymphoscintigraphy and Fluorescence Lymphangiography.

Abstract

Background: Sentinel lymph node biopsy (SLNB) plays a crucial role in the clinical staging of cutaneous melanoma, influencing both treatment decisions and survival prognosis. This study aims to evaluate the benefits of combining indocyanine green (ICG) angiography with sentinel lymphoscintigraphy compared to the use of isolated sentinel lymphoscintigraphy.

Materials and methods: A retrospective analysis was conducted comparing patients who underwent SLNB with isolated sentinel lymphoscintigraphy (isolated group) to those who received SLNB with a combined approach involving both sentinel lymphoscintigraphy and ICG lymphangiography (combined group). The success rates of SLNB, the incidence of false negatives, and the feasibility of using ICG alone were assessed.

Results: The success rate for detecting at least 1 lymph node was 92.6% in the isolated group and 100% in the combined group. Among the 16 patients in the isolated group with negative SLNB results, 3 (18.7%) experienced lymph node recurrence. In contrast, none of the 16 patients in the combined group exhibited recurrence ( P > 0.05). The combined method resulted in a 26.7% increase in the average number of excised lymph nodes compared to the isolated method.

Conclusions: The integration of ICG lymphangiography with sentinel lymphoscintigraphy enhances lymph node sampling and detection sensitivity, thereby reducing the false-negative rate. However, there is insufficient evidence to support the adequacy of using ICG alone for SLNB.