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Detection rates of sentinel lymph node in vulvar cancer using the new protocol with indocyanine-green fluorescence: Time to abandon both blue dye as well as 99mTc-labeled colloid lymphoscintigraphy protocols?

Published:November 07, 2022DOI:https://doi.org/10.1016/j.ejso.2022.11.001
      With great deal of interest, we read the article entitled: “Comparison of ICG-NIR with blue dye and technetium for the detection of sentinel lymph nodes in vulvar cancer” by Rundle et al. [
      • Rundle S.
      • et al.
      A comparison of ICG-NIR with blue dye and technetium for the detection of sentinel lymph nodes in vulvar cancer.
      ]. The authors present a 92% detection rate of sentinel lymph nodes in vulvar cancer patients using a new protocol with the combination of ICG-NIR and 99mTc-nanocolloid compared to 69% with the older protocol of blue dye combined with 99mTc-nanocolloid. Based on their findings, abandonment of routine use of blue dye is proposed [
      • Rundle S.
      • et al.
      A comparison of ICG-NIR with blue dye and technetium for the detection of sentinel lymph nodes in vulvar cancer.
      ].
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      References

        • Rundle S.
        • et al.
        A comparison of ICG-NIR with blue dye and technetium for the detection of sentinel lymph nodes in vulvar cancer.
        Eur J Surg Oncol. 2022 Sep 28; (00685-0): S0748-S7983
        • Di Donna M.C.
        • et al.
        Detection of sentinel lymph node in vulvar cancer using 99mTc-labeled colloid lymphoscintigraphy, blue dye, and indocyanine-green fluorescence: a meta-analysis of studies published in 2010-2020.
        Arch Gynecol Obstet. 2022 May 24;
        • Siegenthaler F.
        • et al.
        Exploratory study of the clinical value of near-infrared sentinel lymph node mapping with indocyanine green in vulvar cancer patients.
        Front Oncol. 2021; 11652458
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        • Grivas N.
        • van Leeuwen F.
        Comprehensive assessment of indocyanine green usage: one tracer, multiple urological applications.
        Eur Urol Focus. 2018; 4: 665-668