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

Shinichi Togami, Hiroaki Kobayashi, Hitoshi Niikura, Muneaki Shimada, Nobuyuki Susumu, Tomohito Tanaka, Yoshito Terai, Tomoyuki Nagai, Tsukasa Baba, Hideaki Yahata, Wataru Yamagami, Ken Yamaguchi, Tsuyoshi Yamashita, Nobuo Yaegashi, Hidetaka Katabuchi, Daisuke Aoki

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)971-979
Number of pages9
JournalInternational Journal of Clinical Oncology
Volume26
Issue number5
DOIs
Publication statusPublished - 2021 May

Keywords

  • Cervical cancer
  • Endometrial cancer
  • Sentinel lymph node biopsy
  • Survey
  • Vulvar cancer

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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