Indocyanine Green Improves Sentinel Node Detection in Uterine Malignancies

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Overall, 257 vs 527 SLNs were detected by isosulfan blue vs ICG, respectively.
Overall, 257 vs 527 SLNs were detected by isosulfan blue vs ICG, respectively.
The following article features coverage from the Society of Gynecologic Oncology 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Interstitial injection of indocyanine green (ICG) significantly improves sentinel lymph node (SLN) detection among women with cervical and uterine cancers, according to findings presented at the 2018 Society of Gynecologic Oncology Annual Meeting on Women's Cancer in New Orleans.1

Although ICG is used for lymphatic mapping and SLN biopsy, it does not currently have US Food and Drug Administration (FDA) approval and is considered off-label for these tasks.

For this prospective study, researchers randomly assigned 180 patients with cervical or uterine cancers to undergo intraoperative cervical injection with isosulfan blue followed by ICG or vice versa. All laparoscopic surgeries were performed using a camera system equipped with near infrared imaging; SLNs were detected with a white light for isosulfan blue and infrared imaging for ICG.

There were 176 evaluable patients at time of analysis. A total of 545 SLNs were detected, with at least 1 SLN detected in 172 patients and bilateral SLNs identified in 143 patients.

At least 1 SLN was detected in 168 (95.5%) patients with ICG vs 131 (74.4%) patients injected with isosulfan blue (P < .001), and bilateral SLNs were detected in 138 (80.2%) patients using ICG compared with 54 (31.4%) patients using isosulfan blue (P < .001).

Overall, 257 vs 527 SLNs were detected by isosulfan blue vs ICG, respectively.

After a minimum 30 days of follow-up for assessment of adverse events, there were no reports of toxicity attributed to either agent.

The authors concluded that “ICG with near infrared visualization should become the standard dye for SLN mapping of uterine malignancy where the technology is available.”

Read more of Cancer Therapy Advisor's coverage of the Society of Gynecologic Oncology 2018 meeting by visiting the conference page.

Reference

  1. Frumovitz M, Plante M, Lee PS, et al. The FILM Trial: A randomized phase III multicenter study assessing near infrared fluorescence in the identification of sentinel lymph nodes (SLN). Oral presentation at: 2018 Society of Gynecologic Oncology Annual Meeting on Women's Cancer; March 24-27, 2018; New Orleans, LA.

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