ICG-guided colorectal cancer surgery linked to higher lymph-node yield and better cancer-specific survival

Researchers retrospectively studied 367 patients who underwent laparoscopic radical resection for colorectal cancer at one center between December 2016 and December 2020. They compared patients treated with ICG fluorescence guidance with those receiving conventional laparoscopic surgery. After propensity-score matching, the analysis included 204 patients: 133 in the ICG group and 71 in the non-ICG group. Disease-free survival was the primary endpoint; secondary endpoints included overall and cancer-specific survival, lymph-node yield, and postoperative complications.

The mean number of harvested lymph nodes was higher with ICG guidance (15.2 vs 12.9; p=0.036), as was the mean number of negative nodes (13.5 vs 11.2; p=0.038). Cancer-specific survival was significantly better in the ICG group. In multivariable analysis, ICG guidance was associated with lower cancer-specific mortality (HR 0.303, 95% CI 0.113–0.812; p=0.018). Subgroup analysis reported better disease-free and cancer-specific survival among patients with stage III disease.

The findings suggest a possible association between ICG guidance and improved oncologic outcomes, but the retrospective, single-center design cannot establish causality. Propensity matching does not eliminate unmeasured confounding, and the supplied report does not provide absolute survival estimates or follow-up duration.