Vercellino GF*, Lichtenberg P, Muallem MZ, Erdemoglu E, Richter R, Abu-Rustum NR, Plante M, Lécuru F, Greggi S, Monk BJ, Sagae S, Denkert C, Keller M, Alhakeem M, Hellriegel M, Dückelmann AM and Sehouli J
Department of Gynecology, Charité Universitätsmedizin, Berlin, GermanyFulltext PDF
Purpose: To evaluate the practice patterns among centers and physicians worldwide regarding Sentinel Lymph Node Biopsies (SLNB) in Cervical Cancer (CC) patients.Method: A validated 35-item questionnaire regarding SLNB in CC supported by the Gynecologic Cancer Intergroup (GCIG), and sponsored by the North-Eastern German Society of Gynaecologic-Oncology (NOGGO) was sent to all major gynecological cancer society's across the globe for further distribution from October 2015 and continued for a period of 7 months.Results: One hundred and sixty-one institutions from around the world participated. One hundred and six (66%) of the participants were from university centers and one hundred and eleven (69%) were gynecologic oncologists. One hundred and fifty-two (97%) performed lymphadenectomy (LNE), and one hundred and forty-seven (94%) did so systematically; Ninety-seven (60%) used SLNB, due to lower morbidity (73%), reliability (55%) and time-saving (27%).In cases of positive SLNB (pN+), 39% of respondents stopped the operation and sent the patient for Chemoradiation (CRT), 45% completed pelvic and paraaortic LNE, whereas 26% went on to perform a Radical Hysterectomy (RH) and systematic pelvic and paraaortic LNE.In case of negative SLNB (pN0), 39% of institutions still performed a systematic pelvic and paraaortic LNE.Conclusion: In this survey worldwide SLNB adoption is an encouraging 60%, yet ample differences exist regarding strategy, and to a lower extent the techniques used. Lack of experience is the most common reason SLNB is not performed.Efforts to increase surgical education on SLNB technique and multicenter prospective trials providing evidence-based guidelines are warranted.
Vercellino GF, Lichtenberg P, Muallem MZ, Erdemoglu E, Richter R, AbuRustum NR, et al. A GCIG International Survey: Clinical Practice Patterns of Sentinel Lymph Node Biopsies in Cervical Cancer. Clin Oncol. 2018; 3: 1558.