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Near-infrared fluorescence imaging compared to standard sentinel lymph node detection with blue dye in patients with vulvar cancer
- Source :
- Gynecologic Oncology, 159(3), 672-680. ACADEMIC PRESS INC ELSEVIER SCIENCE, Gynecologic Oncology, 159(3), 672-680. Academic Press
- Publication Year :
- 2020
- Publisher :
- ACADEMIC PRESS INC ELSEVIER SCIENCE, 2020.
-
Abstract
- Objective. The aim of this study was to assess the superiority of ICG-Tc-99m-nanocolloid for the intraoperative visual detection of sentinel lymph nodes (SLNs) in vulvar squamous cell carcinoma (VSCC) patients compared to standard SLN detection using Tc-99m-nanocolloid with blue dye.Methods. In this multicenter, randomized controlled trial, VSCC patients underwent either the standard SLN procedure or with the hybrid tracer ICG-Tc-99m-nanocolloid. The primary endpoint was the percentage of fluorescent SLNs compared to blue SLNs. Secondary endpoints were successful SLN procedures, surgical outcomes and postoperative complications.Results. Forty-eight patients were randomized to the standard (n = 24) or fluorescence imaging group (n = 24) using ICG-Tc-99m-nanocolloid. The percentage of blue SLNs was 65.3% compared to 92.5% fluorescent SLNs (p < 0.001). A successful SLN procedure was obtained in 92.1% of the groins in the standard group and 97.2% of the groins in the fluorescence imaging group (p = 0.33). Groups did not differ in surgical outcome, although more short-term postoperative complications were documented in the standard group (p = 0.041).Conclusions. Intraoperative visual detection of SLNs in patients with VSCC using ICG-Tc-99m-nanocolloid was superior compared to Tc-99m-nanocolloid and blue dye. The rate of successful SLN procedures between both groups was not significantly different. Fluorescence imaging has potential to be used routinely in the SLN procedure in VSCC patients to facilitate the search by direct visualization. Clinical Trial Registration: Netherlands Trial Register (Trial ID NL7443). (C) 2020 The Author(s). Published by Elsevier Inc.
- Subjects :
- 0301 basic medicine
Near-Infrared Fluorescence Imaging
Time Factors
Vulvar Squamous Cell Carcinoma
law.invention
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
law
ICG-Tc-99m-nanocolloid
Clinical endpoint
Coloring Agents
Netherlands
Aged, 80 and over
Vulvar Neoplasms
Vulvar cancer
Optical Imaging
Obstetrics and Gynecology
Middle Aged
Indocyanine green
3. Good health
Oncology
030220 oncology & carcinogenesis
Lymphatic Metastasis
Carcinoma, Squamous Cell
Vulvectomy
Female
Lymph
Sentinel lymph node
Adult
Operative Time
Near-infrared fluorescence imaging
03 medical and health sciences
SDG 3 - Good Health and Well-being
medicine
Humans
Aged
Intraoperative Care
business.industry
Sentinel Lymph Node Biopsy
medicine.disease
body regions
030104 developmental biology
chemistry
Lymph Node Excision
Radiopharmaceuticals
business
Nuclear medicine
Subjects
Details
- Language :
- English
- ISSN :
- 00908258
- Database :
- OpenAIRE
- Journal :
- Gynecologic Oncology, 159(3), 672-680. ACADEMIC PRESS INC ELSEVIER SCIENCE, Gynecologic Oncology, 159(3), 672-680. Academic Press
- Accession number :
- edsair.doi.dedup.....1042e39d1cc1513ab2e2cb8f8bdb3bde