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Survey of the clinical practice pattern of using sentinel lymph node biopsy in patients with gynecological cancers in Japan: the Japan Society of Gynecologic Oncology study

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Abstract

Background

Sentinel lymph node (SN) biopsy is essential for evaluating survival and minimal treatment-related morbidity associated with cervical, endometrial, and vulvar cancer in Japan. As such, our aim in this study was to evaluate the current practice pattern of using SN biopsy for cervical, endometrial, and vulvar cancer in Japan.

Methods

We deployed a 47-question survey on the use of SN biopsy for gynecological cancers to 216 gynecological oncology training facilities. The survey included information on the use of SN biopsy for uterine (cervical and endometrial) and vulvar cancers; details on the type, timing, and concentration of tracers used; surgical approach used for SN biopsy; method of biopsy and pathological examination; and facilities’ experience with clinical research on SN biopsy.

Results

The response rate was 84% (181/216), with 40 facilities (22%) having experience in SN biopsy for gynecological cancers, 34 (85%) for uterine cancers, and 15 (37%) for vulvar cancers. Radioisotope, indocyanine green (ICG), and blue dyes were available for the detection of uterine cancers in 21 (52%), 25 (62%), and 19 (48%) facilities and for vulvar cancers in 9 (22%), 3 (7%), and 11 (27%) facilities, respectively. Thirty-four facilities (85%) used intraoperative frozen section procedure for diagnosis when possible, with 24 (71%) of these facilities using 2-mm specimen cuts. Diagnosis included pathological examination (85%), immunostaining (57%), and one-step nucleic acid amplification (5%).

Conclusion

Increasing research evidence, providing insurance coverage for radioisotope tracers, and increasing the availability of training are expected to increase the use of SN biopsy in Japan.

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Acknowledgements

We are grateful to the 40 facilities that responded with the data on sentinel lymph node biopsy. The 40 facilities are as follows: Aichi Cancer Center, Asahikawa Medical College, Cancer Institute Hospital, Chiba University, Dokkyo Medical University, Fukui University, Gifu Prefectural General Medical Center, Gunma Prefectural Cancer Center, Hokkaido Cancer Center, Hakodate Municipal Hospital. Jikei University, Jikei University Daisan Hospital, Juntendo University, Kagoshima University, Kameda Medical Center, Kansai Medical University, Keio University, Kindai University, Kitakyushu Municipal Medical Center, Kobe City Medical Center General Hospital, Koshigaya Municipal Hospital, Kurume University, Kyoundo Hospital, Kyushu University, Mie University, National Hospital Organization Kyushu Cancer Center, Osaka International Cancer Institute, Osaka Medical College, Osaka University, Shinshu University, Shin-yurigaoka General Hospital, Tazuke Kofukai Medical Research Institute Kitano Hospital, Teikyo University, Tohoku University, University of Occupational and Environmental Health, Toyama Prefectural Central Hospital, Toyohashi Municipal Hospital, Yamagata University, Yokohama Municipal Citizen's Hospital.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan

    Shinichi Togami & Hiroaki Kobayashi

  2. Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Japan

    Hitoshi Niikura & Muneaki Shimada

  3. Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan

    Tomoyuki Nagai & Nobuo Yaegashi

  4. Department of Obstetrics and Gynecology, International University of Health and Welfare, Chiba, Japan

    Nobuyuki Susumu

  5. Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan

    Tomohito Tanaka

  6. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshito Terai

  7. Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan

    Tsukasa Baba

  8. Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Hideaki Yahata

  9. Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan

    Wataru Yamagami & Daisuke Aoki

  10. Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Ken Yamaguchi

  11. Department of Obstetrics and Gynecology, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan

    Tsuyoshi Yamashita

  12. Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

    Hidetaka Katabuchi

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  1. Shinichi Togami
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Correspondence to Hiroaki Kobayashi.

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Togami, S., Kobayashi, H., Niikura, H. et al. Survey of the clinical practice pattern of using sentinel lymph node biopsy in patients with gynecological cancers in Japan: the Japan Society of Gynecologic Oncology study. Int J Clin Oncol 26, 971–979 (2021). https://doi.org/10.1007/s10147-021-01862-7

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