Sentinel lymph node biopsy in patients with endometrial cancer and an indocyanine green or iodinated contrast reaction - A proposed management algorithm.
Administration, Intravaginal
Adult
Aged
Aged, 80 and over
Anti-Allergic Agents
/ therapeutic use
Contrast Media
/ administration & dosage
Drug Hypersensitivity
/ epidemiology
Endometrial Neoplasms
/ pathology
Female
Humans
Incidence
Indocyanine Green
/ administration & dosage
Lymphatic Metastasis
/ diagnosis
Middle Aged
Premedication
/ methods
Prospective Studies
Retrospective Studies
Sentinel Lymph Node
/ diagnostic imaging
Sentinel Lymph Node Biopsy
/ adverse effects
Young Adult
Allergy
Contrast allergy
Endometrial cancer
Indocyanine green
Iodine allergy
Sentinel lymph node biopsy
Journal
Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
08
04
2021
accepted:
09
05
2021
pubmed:
17
5
2021
medline:
15
12
2021
entrez:
16
5
2021
Statut:
ppublish
Résumé
To describe the incidence of adverse reactions to indocyanine green (ICG) administered during sentinel lymph node (SLN) biopsy for endometrial cancer, and to propose an ICG management algorithm for these patients. All patients who underwent surgery for endometrial cancer with SLN biopsy using ICG from 1/2017 to 8/2020 were identified using a single-institution prospective database. Surgical adverse events (SAEs) related to the procedure were identified. A review of the literature was performed. In all, 1414 patients met inclusion criteria and were evaluated. Sixty-seven (4.7%) patients had a history of either an iodine or contrast allergy. No patients had a history of documented ICG allergy. Among patients with an iodine or contrast allergy, 65 (97%) received a corticosteroid with or without diphenhydramine prior to ICG administration. One hundred five patients (7.4%) experienced 116 SAEs. Among these patients, 3 experienced potentially allergic SAEs possibly related to ICG administration. After thorough chart review, however, the likelihood these SAEs were due to ICG appeared low. No patients experienced an anaphylactic response after ICG admission. There were no anaphylactic reactions to ICG intracervical administration during 1414 consecutive SLN biopsies, including in patients with a documented iodine or contrast allergy. Intracervical injection of ICG is safe, and premedication using corticosteroids with or without diphenhydramine prior to SLN biopsy is a reasonable strategy in patients with iodinated contrast allergy.
Identifiants
pubmed: 33992449
pii: S0090-8258(21)00405-4
doi: 10.1016/j.ygyno.2021.05.009
pmc: PMC8319058
mid: NIHMS1705803
pii:
doi:
Substances chimiques
Anti-Allergic Agents
0
Contrast Media
0
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
262-267Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Outside the submitted work, Dr. Abu-Rustum reports institutional grants from Stryker/Novadaq, Olympus, and GRAIL. Dr. Leitao reports personal fees from J&J/Ethicon and Intuitive Surgical, Inc. The other authors have no potential conflicts of interest to disclose.
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