Evidence map›Paper›PMID 37402976›Full record

Trial reportAnnals of surgical oncology2023

Novel Dual Tracer Indocyanine Green and Radioisotope Versus Gold Standard Sentinel Lymph Node Biopsy in Breast Cancer: The GREENORBLUE Trial.

Chu Luan Nguyen, Michael Zhou, Neshanth Easwaralingam, Jue Li Seah, Farhad Azimi, Cindy Mak, Carlo Pulitano, Sanjay Warrier

Open access · hybridAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
6.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Chu Luan NguyenDepartment of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia. Chuluannguyen@gmail.com.ORCID http://orcid.org/0000-0002-4630-6182
Michael ZhouDepartment of Surgery, The University of Sydney, Camperdown, NSW, Australia.
Neshanth EaswaralingamDepartment of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
Jue Li SeahDepartment of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
Farhad AzimiDepartment of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
Cindy MakDepartment of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
Carlo PulitanoDepartment of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Sanjay WarrierDepartment of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
The University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe methods for sentinel lymph node (SLN) biopsy in breast cancer have been variable in type and number of tracers. Some units have abandoned the use of blue dye (BD) due to adverse reactions. Fluorescence-guided biopsy with indocyanine green (ICG) is a relatively novel technique. This study compared the clinical efficacy and costs between novel dual tracer ICG and radioisotope (ICG-RI) with "gold standard" BD and radioisotope (BD-RI).

methodsSingle-surgeon study of 150 prospective patients with early breast cancer undergoing SLN biopsy (2021-2022) using ICG-RI compared with a retrospective cohort of 150 consecutive previous patients using BD-RI. Number of SLNs identified, rate of failed mapping, identification of metastatic SLNs, and adverse reactions were compared between techniques. Cost-minimisation analysis performed by using Medicare item numbers and micro-costing analysis.

resultsTotal number of SLNs identified with ICG-RI and BD-RI was 351 and 315, respectively. Mean number of SLNs identified with ICG-RI and BD-RI was 2.3 (standard deviation [SD] 1.4) and 2.1 (SD 1.1), respectively (p = 0.156). There were no cases of failed mapping with either dual technique. Metastatic SLNs were identified in 38 (25.3%) ICG-RI patients compared with 30 (20%) BD-RI patients (p = 0.641). There were no adverse reactions to ICG, whereas four cases of skin tattooing and anaphylaxis were associated with BD (p = 0.131). ICG-RI cost an additional AU$197.38 per case in addition to the initial cost for the imaging system. CLINICAL

trial registrationACTRN12621001033831.

conclusionsNovel tracer combination, ICG-RI, provided an effective and safe alternative to "gold standard" dual tracer. The caveat was the significantly greater costs associated with ICG.

Indexed as

Breast NeoplasmsSentinel Lymph NodeAgedColoring AgentsFemaleFluorescent DyesHumansIndocyanine GreenLymph NodesMedicareProspective StudiesRadioisotopesRetrospective StudiesSentinel Lymph Node BiopsyUnited StatesColoring AgentsFluorescent DyesIndocyanine GreenRadioisotopes

Identifiers

PMID37402976
PMCPMC10507001
OpenAlexW4383100928

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.