Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices
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 sentine...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/2048 |
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| author | Roxana Schwab Kathrin Stewen Theresa-Louise Bührer Mona W. Schmidt Josche van der Ven Katharina Anic Valerie C. Linz Bashar Haj Hamoud Walburgis Brenner Katharina Peters Anne-Sophie Heimes Katrin Almstedt Slavomir Krajnak Wolfgang Weikel Marco J. Battista Christian Dannecker Annette Hasenburg |
| author_facet | Roxana Schwab Kathrin Stewen Theresa-Louise Bührer Mona W. Schmidt Josche van der Ven Katharina Anic Valerie C. Linz Bashar Haj Hamoud Walburgis Brenner Katharina Peters Anne-Sophie Heimes Katrin Almstedt Slavomir Krajnak Wolfgang Weikel Marco J. Battista Christian Dannecker Annette Hasenburg |
| author_sort | Roxana Schwab |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T07:19:28Z |
| format | Article |
| id | doaj.art-40df9919ee8248408f7b4f2e0d5c5c81 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:19:28Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-40df9919ee8248408f7b4f2e0d5c5c812023-11-17T08:01:54ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01125204810.3390/jcm12052048Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of PracticesRoxana Schwab0Kathrin Stewen1Theresa-Louise Bührer2Mona W. Schmidt3Josche van der Ven4Katharina Anic5Valerie C. Linz6Bashar Haj Hamoud7Walburgis Brenner8Katharina Peters9Anne-Sophie Heimes10Katrin Almstedt11Slavomir Krajnak12Wolfgang Weikel13Marco J. Battista14Christian Dannecker15Annette Hasenburg16Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, 66421 Homburg, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Augsburg, Stenglinstr. 2, 86156 Augsburg, GermanyDepartment of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, GermanyBackground: 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.https://www.mdpi.com/2077-0383/12/5/2048vulvar cancerrare diseasesentinel node biopsyguidelinescertified oncological center |
| spellingShingle | Roxana Schwab Kathrin Stewen Theresa-Louise Bührer Mona W. Schmidt Josche van der Ven Katharina Anic Valerie C. Linz Bashar Haj Hamoud Walburgis Brenner Katharina Peters Anne-Sophie Heimes Katrin Almstedt Slavomir Krajnak Wolfgang Weikel Marco J. Battista Christian Dannecker Annette Hasenburg Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices Journal of Clinical Medicine vulvar cancer rare disease sentinel node biopsy guidelines certified oncological center |
| title | Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices |
| title_full | Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices |
| title_fullStr | Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices |
| title_full_unstemmed | Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices |
| title_short | Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany: A Web-Based Nationwide Analysis of Practices |
| title_sort | current approaches to the management of sentinel node procedures in early vulvar cancer in germany a web based nationwide analysis of practices |
| topic | vulvar cancer rare disease sentinel node biopsy guidelines certified oncological center |
| url | https://www.mdpi.com/2077-0383/12/5/2048 |
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