Sentinel lymph node mapping for endometrial and cervical cancer in Denmark

Area of Science:

• Gynaecological Oncology
• Surgical Innovation
• Clinical Trials

Background:

• Pilot study introducing sentinel lymph node (SLN) mapping for early-stage cervical cancer (CC) and endometrial cancer (EC) in Denmark.
• Aimed to standardize surgical training and ensure surgeon proficiency in SLN mapping.
• Preceded larger national prospective studies on oncological safety and patient selection.

Purpose of the Study:

• To systematically introduce and evaluate the technique of sentinel lymph node (SLN) mapping in women with early-stage cervical and endometrial cancer.
• To facilitate structured surgical training and ensure surgeon proficiency.
• To assess the feasibility of achieving international-level SLN detection rates within a defined training period.

Main Methods:

• Surgical pilot study conducted across four Danish gynaecological cancer centres (September 2016 - August 2019).
• Protocolled introduction to SLN mapping technique, including pelvic lymphatic drainage and pathological ultra-staging.
• Performance criterion set at a total SLN detection rate > 80% based on 30 procedures per centre.

Main Results:

• Four centres performed a total of 140 procedures (30-46 per centre).
• Achieved a cumulative total SLN detection rate of 91.3% (68.8% bilateral, 22.5% unilateral).
• Three centres exceeded the 80% detection criterion from the start; one centre achieved it after 20 procedures.

Conclusions:

• All participating centres demonstrated international-level sentinel lymph node detection rates within 30 procedures.
• The study successfully met its criterion for surgeon proficiency.
• Centres were deemed eligible to proceed to national prospective studies on SLN mapping in CC and EC.