In a meta-analysis of 7,518 patients, ICG-guided lymphadenectomy was associated with better 3- and 5-year survival and greater node yield—but the evidence does not establish causation.

• Hazard ratios were 0.64 for 3-year overall survival, 0.68 for 3-year disease-free survival, and 0.70 for 5-year overall survival; 2-year survival did not differ significantly.
• ICG yielded about 6.6 additional lymph nodes on average, with no significant difference in postoperative complications.

The findings support ICG as a promising adjunct, not yet a proven survival-improving intervention; randomized trials are needed to confirm the association.