Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices.

Autor: Schwab R; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Stewen K; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Bührer TL; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Schmidt MW; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., van der Ven J; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Anic K; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Linz VC; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Hamoud BH; Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, 66421 Homburg, Germany., Brenner W; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Peters K; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Heimes AS; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Almstedt K; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Krajnak S; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Weikel W; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Battista MJ; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany., Dannecker C; Department of Gynecology and Obstetrics, University Medical Center Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany., Hasenburg A; Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Mar 04; Vol. 12 (5). Date of Electronic Publication: 2023 Mar 04.
DOI: 10.3390/jcm12052048
Abstrakt: Background: Lymph node involvement is the most important prognostic factor for recurrence and survival in vulvar cancer. Sentinel node (SN) procedure can be offered in well-selected patients with early vulvar cancer. This study aimed to assess current management practices with respect to the sentinel node procedure in women with early vulvar cancer in Germany.
Methods: A Web-based survey was conducted. Questionnaires were e-mailed to 612 gynecology departments. Data were summarized as frequencies and analyzed using the chi-square test.
Results: A total of 222 hospitals (36.27%) responded to the invitation to participate. Among the responders, 9.5% did not offer the SN procedure. However, 79.5% evaluated SNs by ultrastaging. In vulvar cancer of the midline with unilateral localized positive SN, 49.1% and 48.6% of respondents, respectively, would perform ipsilateral or bilateral inguinal lymph node dissection. Repeat SN procedure was performed by 16.2% of respondents. For isolated tumor cells (ITCs) or micrometastases, 28.1% and 60.5% of respondents, respectively, would perform inguinal lymph node dissection, whereas 19.3% and 23.8%, respectively, would opt for radiation without further surgical intervention. Notably, 50.9% of respondents would not initiate any further therapy and 15.1% would opt for expectant management.
Conclusions: The majority of German hospitals implement the SN procedure. However, only 79.5% of respondents performed ultrastaging and only 28.1% were aware that ITC may affect survival in vulvar cancer. There is a need to ensure that the management of vulvar cancer follows the latest recommendations and clinical evidence. Deviations from state-of-the-art management should only be after a detailed discussion with the concerned patient.
Databáze: MEDLINE
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