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

• Published in: International journal of clinical oncology Vol. 26; no. 5; pp. 971 - 979
• Main Authors: Togami, Shinichi, Kobayashi, Hiroaki, Niikura, Hitoshi, Shimada, Muneaki, Susumu, Nobuyuki, Tanaka, Tomohito, Terai, Yoshito, Nagai, Tomoyuki, Baba, Tsukasa, Yahata, Hideaki, Yamagami, Wataru, Yamaguchi, Ken, Yamashita, Tsuyoshi, Yaegashi, Nobuo, Katabuchi, Hidetaka, Aoki, Daisuke
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-05-2021; Springer Nature B.V
• Subjects: Biopsy; Cancer Research; Cervical cancer; Diagnosis; Endometrial cancer; Endometrium; Genital cancers; Gynecological cancer; Gynecology; Lymph nodes; Lymphatic system; Medicine; Medicine & Public Health; Morbidity; Oncology; Original Article; Radioactive tracers; Radioisotopes; Surgical Oncology; Training; Uterine cancer; Uterus; Japan; Vulvar cancer; Survey; Endometrial cancer; Cervical cancer; Sentinel lymph node biopsy
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-021-01862-7

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.