Abstract / Summary
Sentinel lymph node (SLN) detection in ovarian cancer is feasible when using technetium-99m radiocolloid ( 99m Tc) in combination with blue dye or indocyanine green (ICG). However, their radioactive and fluorescent properties make them challenging to use in laparotomic procedures. This study aims to investigate whether SLN identification is also achievable using Magtrace. This agent imparts a brown colouring to lymph nodes and emits a magnetic signal detectable by a handheld Sentimag probe, allowing for precise localization of the SLN. Patients included underwent a SLN procedure during laparotomy as part of either primary surgery (with frozen section) due to suspected ovarian cancer, or secondary staging following previous resection with confirmed ovarian cancer. Magtrace and 99m Tc were both injected in the ligamentum ovarium proprium and the ligamentum infundibulo-pelvicum or its stumps. After an interval of at least 15 min, the SLN(s) were located using both the Sentimag probe detecting Magtrace as well as the gamma probe related to 99m Tc. Of the 16 patients eligible for participation, 10 received tracer injections: nine during primary staging and one during secondary staging. In the primary staging group, frozen-section analysis showed a benign or borderline tumour in six patients. In the remaining three patients, the SLN procedure was successful, with at least one SLN identified using Magtrace. In the patient who underwent SLN mapping during secondary staging, the procedure was unsuccessful. In patients with EOC, Magtrace injection shows promise for SLN detection, but larger studies are needed to confirm its value. At clinicaltrails.gov Clinical trial ID NCT05375526, registration date 2022-05-16.