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International journal of clinical oncology
May, 2021;26 (5): 971-979.

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
Author Information
  1. Shinichi Togami: Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan.
  2. Hiroaki Kobayashi: Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan. hirokoba@m2.kufm.kagoshima-u.ac.jp. ORCID
  3. Hitoshi Niikura: Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Japan.
  4. Muneaki Shimada: Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Japan.
  5. Nobuyuki Susumu: Department of Obstetrics and Gynecology, International University of Health and Welfare, Chiba, Japan.
  6. Tomohito Tanaka: Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan.
  7. Yoshito Terai: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
  8. Tomoyuki Nagai: Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
  9. Tsukasa Baba: Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
  10. Hideaki Yahata: Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  11. Wataru Yamagami: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
  12. Ken Yamaguchi: Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
  13. Tsuyoshi Yamashita: Department of Obstetrics and Gynecology, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan.
  14. Nobuo Yaegashi: Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
  15. Hidetaka Katabuchi: Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
  16. Daisuke Aoki: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
PMID: 33768450 DOI: 10.1007/s10147-021-01862-7

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.

Keywords

Cervical cancer Endometrial cancer Sentinel lymph node biopsy Survey Vulvar cancer

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Word Cloud

Created with Highcharts 10.0.0biopsySNcancersfacilitiesvulvarcancerJapangynecologicallymphnodecervicalendometrialusinguseuterineused85%Sentinelstudypracticepatternsurveytrainingincludedtracerspathologicalexaminationexperienceclinicalresearch22%SurveyBACKGROUND:essentialevaluatingsurvivalminimaltreatment-relatedmorbidityassociatedaimevaluatecurrentMETHODS:deployed47-question216oncologyinformationdetailstypetimingconcentrationsurgicalapproachmethodfacilities'RESULTS:responserate84%181/21640341537%RadioisotopeindocyaninegreenICGbluedyesavailabledetection2152%2562%1948%937%1127%respectivelyThirty-fourintraoperativefrozensectionprocedurediagnosispossible2471%2-mmspecimencutsDiagnosisimmunostaining57%one-stepnucleicacidamplification5%CONCLUSION:IncreasingevidenceprovidinginsurancecoverageradioisotopeincreasingavailabilityexpectedincreasesentinelpatientsJapan:SocietyGynecologicOncologyCervicalEndometrialVulvar

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