Sentinel lymph node biopsy in patients with endometrial cancer and an indocyanine green or iodinated contrast reaction - A proposed management algorithm Journal Article

   

Authors:	Zammarrelli, W. A. 3rd; Afonso, A. M.; Broach, V.; Sonoda, Y.; Zivanovic, O.; Mueller, J. J.; Leitao, M. M. Jr; Chan, A.; Abu-Rustum, N. R.
Article Title:	Sentinel lymph node biopsy in patients with endometrial cancer and an indocyanine green or iodinated contrast reaction - A proposed management algorithm
Abstract:	Objective: 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. Methods: 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. Results: 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. Conclusion: 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. © 2021 Elsevier Inc.
Keywords:	endometrial cancer; sentinel lymph node biopsy; allergy; indocyanine green; contrast allergy; iodine allergy
Journal Title:	Gynecologic Oncology
Volume:	162
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2021-08-01
Start Page:	262
End Page:	267
Language:	English
DOI:	10.1016/j.ygyno.2021.05.009
PUBMED:	33992449
PROVIDER:	scopus
PMCID:	PMC8319058
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85105777820&doi=10.1016%2fj.ygyno.2021.05.009&partnerID=40&md5=54c1d58dc06fa510256cd74fc35db1fa
Notes:	Article -- Export Date: 1 September 2021 -- Source: Scopus

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