Consensus on surgical technique for sentinel lymph node dissection in cervical cancer

Area of Science:

• Gynecologic Oncology
• Surgical Pathology

Background:

• Sentinel lymph node (SLN) dissection is crucial for accurate staging of cervical cancer.
• Standardized surgical techniques are needed to improve outcomes and reduce morbidity.

Purpose of the Study:

• To establish a consensus on the optimal surgical technique for sentinel lymph node (SLN) dissection in cervical cancer among international experts.

Main Methods:

• A modified Delphi method involving a 26-question survey and semistructured interviews with 38 international gynecological oncology surgeons.
• Consensus was defined as ≥70% agreement.

Main Results:

• Consensus was reached on 15 recommended, 3 optional, and 5 not recommended steps for SLN dissection.
• Recommended techniques include using indocyanine green, specific injection sites, minimally invasive approaches, and careful dissection planes.
• Not recommended steps include injection into the tumor and modifying tracer concentration after mapping failure.

Conclusions:

• A consensus-based surgical guide for SLN dissection in cervical cancer has been established.
• This guide can be utilized in clinical trials and for quality assurance in routine practice to standardize SLN biopsy procedures.