A joint research team from Korea University Guro Hospital has made a significant breakthrough in treating endometrial cancer.
They developed a precise surgical technique that detects and removes metastatic lymph nodes.
The technique uses a novel fluorescent agent, neo-mannosyl human serum albumin-indocyanine green (MSA-ICG), combined with a laparoscopic fluorescence imaging system. It enables surgeons to selectively target and remove cancerous lymph nodes during surgery.
Endometrial cancer, whose global incidence has been steadily rising, often spreads through the lymphatic system.
Traditionally, extensive lymph node dissection has been employed to identify and remove potential metastatic sites, but this invasive method can result in complications, such as lower limb lymphedema.
To address this, the research team led by Professor Hyun-Woong Cho (Gynaecologic Cancer Centre) and Professor Hyun Koo Kim (Department of Thoracic and Cardiovascular Surgery) aimed to develop a less invasive, more targeted approach.
In their study, the team compared the efficacy of conventional indocyanine green (ICG) with the newly developed MSA-ICG in an animal model of uterine cancer with lymph node metastasis.
Their findings, published in the International Journal of Surgery, reveal that MSA-ICG greatly enhances fluorescent signals in metastatic lymph nodes by increasing CD206 expression. This allows for clear differentiation between cancerous and normal lymph nodes – a critical improvement over standard ICG.
Professor Cho said: ‘This method offers real-time detection of metastatic lymph nodes, enabling precise removal of cancerous tissue without extensive lymph node dissection.’
He emphasised this new technique’s potential to reduce surgical complications and improve patient outcomes by minimising unnecessary tissue removal.
The significance of this discovery extends beyond endometrial cancer. Professor Kim, a co-developer of MSA-ICG, highlighted ongoing efforts to adapt this technique for other cancers, such as lung, oesophagal, breast and colorectal cancer, where precise lymph node targeting is crucial.
The fluorescent agent MSA-ICG, developed by Professor Kim in collaboration with Professor Emeritus Jae Min Jeong from Seoul National University’s Department of Nuclear Medicine, has been patented and licensed to CellBion Co Ltd for commercial production, marking a critical step toward clinical implementation.
