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A GCIG international survey: clinical practice patterns of sentinel lymph node biopsies in cervical cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

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 societies 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 111 (69%) were gynecologic oncologists. One hundred and fifty-two (97%) performed lymphadenectomy (LNE) and 147 (94%) did so systematically; 97 (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.

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Author information

Authors and Affiliations

  1. Department of Gynecology With Center for Oncological Surgery, Charité Universtitätmedizin, Charité Platz 1, 10117, Berlin, Germany

    G. F. Vercellino, P. Lichtenberg, M. Z. Muallem, R. Richter, M. Keller, M. Alhakeem, A. M. Dückelmann & Jalid Sehouli

  2. Department of Gynecologic Oncology, Suleyman Demirel University, Isparta, Turkey

    E. Erdemoglu

  3. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    N. R. Abu-Rustum

  4. Division of Gynecologic Oncology, Centre Hospitalier Universitaire de Laval Québec, Quebec, Canada

    M. Plante

  5. Department of Gynecologic Oncologic and Breast Surgery, Hôpital Européen Georges Pompidou (HEGP), Paris, France

    F. Lécuru

  6. Université Paris Descartes, Paris, France

    F. Lécuru

  7. Gynecologic Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori di Napoli, Naples, Italy

    S. Greggi

  8. University of Arizona Cancer Center-Phoenix, Creighton University School of Medicine at St Joseph’s Hospital and Medical Center, Phoenix, AZ, USA

    B. J. Monk

  9. Department of Gynecologic Oncology, Sapporo West Kojinkai Clinic, Sapporo, Japan

    S. Sagae

  10. Obstetrics and Gynaecology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    M. Alhakeem

  11. Department of Pathology, Charité Universtitätmedizin, Berlin, Germany

    C. Denkert

  12. Clinic for Obstetrics and Gynecology, UMG Universitätmedizin, Göttingen, Germany

    M. Hellriegel

  13. Department of Gynecologic Oncology, University of Palermo, Palermo, Italy

    V. Chiantera

  14. UMG Universität Medizin Göttingen, 37075, Göttingen, Germany

    G. F. Vercellino

  15. ESGO Center of Excellence Ovarian Cancer Surgery, ESGO Accredited European Training Centre in Gynaecological Oncology, Charité Comprehensive Cancer Center (CCCC), Universitätsmedizin Berlin Charité/Medical University of Berlin, Augustenburger Platz 1, Mittelallee 9, 1st Floor, Room No. 1.3073, 13353, Berlin, Germany

    Jalid Sehouli

Authors
  1. G. F. Vercellino
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  2. E. Erdemoglu
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  3. P. Lichtenberg
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  4. M. Z. Muallem
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  6. N. R. Abu-Rustum
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  7. M. Plante
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  8. F. Lécuru
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  16. A. M. Dückelmann
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  17. V. Chiantera
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  18. Jalid Sehouli
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Contributions

GFV: idea, questionnaire editing, questionnaire editing revision, data collection, manuscript editing, table editing, manuscript revision; EE: data collection, manuscript revision; PL: data collection; MZM: data collection; RR: data collection; NAR: data collection, manuscript revision; MP: data collection, manuscript revision; FL: data collection, manuscript revision; SG: data collection; BJM: data collection, manuscript revision; SS: data collection, manuscript revision; MA: data collection; CD: data collection; MK: questionnaire and reminder posting, contact with centers, manuscript revision; MH: data collection; AMD: data collection; VC: data collection, manuscript revision; JS: questionnaire editing revision, data collection, manuscript revision.

Corresponding authors

Correspondence to G. F. Vercellino or Jalid Sehouli.

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Conflict of interest

No actual or potential conflict of interest in relation to this article exists. Specifically, Bradley Monk has consulted for Roche Inc, Genmab and Advaxis; other authors declare no conflicts of interest. Thanks to: Ione und Costas Tziouvas for their very precious help editing the article.

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Vercellino, G.F., Erdemoglu, E., Lichtenberg, P. et al. A GCIG international survey: clinical practice patterns of sentinel lymph node biopsies in cervical cancer. Arch Gynecol Obstet 300, 191–199 (2019). https://doi.org/10.1007/s00404-019-05164-2

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