TY - JOUR
T1 - Factors influencing the adoption of the sentinel lymph node technique for endometrial cancer staging
T2 - An international survey of gynecologic oncologists
AU - Casarin, Jvan
AU - Multinu, Francesco
AU - Abu-Rustum, Nadeem
AU - Cibula, David
AU - Cliby, William A.
AU - Ghezzi, Fabio
AU - Leitao, Mario
AU - Konishi, Ikuo
AU - Nam, Joo Hyun
AU - Querleu, Denis
AU - Soliman, Pamela T.
AU - Yost, Kathleen J.
AU - Weaver, Amy L.
AU - Mariani, Andrea
AU - Glaser, Gretchen E.
N1 - Publisher Copyright:
© 2019 IGCS and ESGO.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective To explore the factors influencing adoption of the sentinel lymph node (SLN) technique for endometrial cancer staging among gynecologic oncologists. Methods A self-administered, web-based survey was sent via email (April 20 through May 21, 2017) to all members of European Society of Gynecologic Oncologists, International Gynecologic Cancer Society, and Society of Gynecologic Oncologists. Surgical and pathologic practices related to SLN and reasons for not adopting this technique were investigated. Results Overall, 489 attending physicians or consultants in gynecologic oncology from 69 countries responded: 201 (41.1%), 118 (24.1%), and 117 (23.9%) from Europe, the USA, and other countries, respectively (10.8% did not report a country). SLN was adopted by 246 (50.3%) respondents, with 93.1% injecting the cervix and 62.6 % using indocyanine green dye. The National Comprehensive Cancer Network SLN algorithm was followed by 160 (65.0%) respondents (USA 74.4%, Europe 55.4%, other countries 71.4%). However, 66.7% completed a backup lymphadenectomy in high-risk patients. When SLN biopsy revealed isolated tumor cells, 13.8% of respondents recommended adjuvant therapy. This percentage increased to 52% if micrometastases were detected. Among the 243 not adopting SLN, 50.2% cited lack of evidence and 45.3% stated that inadequate instrumentation fueled their decisions. Conclusions SLN with a cervical injection is gaining widespread acceptance for staging of endometrial cancer among gynecologic oncologists worldwide. Standardization of the surgical approach with the National Comprehensive Care Network algorithm is applied by most users. Management of isolated tumor cells and the role of backup lymphadenectomy for high-risk' cases remain areas of investigation.
AB - Objective To explore the factors influencing adoption of the sentinel lymph node (SLN) technique for endometrial cancer staging among gynecologic oncologists. Methods A self-administered, web-based survey was sent via email (April 20 through May 21, 2017) to all members of European Society of Gynecologic Oncologists, International Gynecologic Cancer Society, and Society of Gynecologic Oncologists. Surgical and pathologic practices related to SLN and reasons for not adopting this technique were investigated. Results Overall, 489 attending physicians or consultants in gynecologic oncology from 69 countries responded: 201 (41.1%), 118 (24.1%), and 117 (23.9%) from Europe, the USA, and other countries, respectively (10.8% did not report a country). SLN was adopted by 246 (50.3%) respondents, with 93.1% injecting the cervix and 62.6 % using indocyanine green dye. The National Comprehensive Cancer Network SLN algorithm was followed by 160 (65.0%) respondents (USA 74.4%, Europe 55.4%, other countries 71.4%). However, 66.7% completed a backup lymphadenectomy in high-risk patients. When SLN biopsy revealed isolated tumor cells, 13.8% of respondents recommended adjuvant therapy. This percentage increased to 52% if micrometastases were detected. Among the 243 not adopting SLN, 50.2% cited lack of evidence and 45.3% stated that inadequate instrumentation fueled their decisions. Conclusions SLN with a cervical injection is gaining widespread acceptance for staging of endometrial cancer among gynecologic oncologists worldwide. Standardization of the surgical approach with the National Comprehensive Care Network algorithm is applied by most users. Management of isolated tumor cells and the role of backup lymphadenectomy for high-risk' cases remain areas of investigation.
KW - endometrial cancer
KW - lymphadenectomy
KW - minimally invasive surgery
KW - sentinel lymph node
KW - survey
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U2 - 10.1136/ijgc-2018-000020
DO - 10.1136/ijgc-2018-000020
M3 - Article
C2 - 30640685
AN - SCOPUS:85060052368
SN - 1048-891X
VL - 29
SP - 60
EP - 67
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
IS - 1
ER -