Optimizing Nodal Staging in Intermediate and High-Risk Prostate Cancer: An Examination of Sentinel Lymph Node Dissection Using ICG/NIR

Abstract

This study evaluated the use of sentinel lymph node (SLN) dissection with indocyanine green/near-infrared (ICG/NIR) technology in laparoscopic radical prostatectomy for clinically localized prostate cancer (PCa). Conducted from 2020 to 2023, the study included 60 patients: 45 at intermediate or high risk underwent both SLN dissection and extended pelvic lymph node dissection (ePLND), while 15 low-risk patients had SLN dissection only. Sentinel nodes were identified in over 90% of cases. Body mass index (BMI) was found to influence the time taken to locate SLNs. Among intermediate and high-risk patients, 22% showed metastatic involvement. The procedure demonstrated a specificity of 90%, sensitivity of 80%, and positive predictive value of 95,7%. The study concludes that SLN dissection is a feasible and effective method for preoperative nodal staging in PCa, although further research is needed for optimization.