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    • Global Survey on Training and Practice in Sentinel Lymph Node Mapping for Endometrial and Cervical Cancer among Early Career Gynecologic Oncologists

    International journal of gynecological cancer official journal of the International Gynecological Cancer Society（2024）

    Medical University of Innsbruck | National Taiwan University Hospital | Universidad de Navarra | Kinshasa University Hospital | Karolinska Institute | General Hospital of Athens Alexandra | Medical University of Warsaw | University of Zielona Gora | Vall d'Hebron Hospital | Klinikum Mittelbaden | University Hospital Basel | Oncologic Surgery Paris | The Royal Marsden Hospital | Private Hospital Villach | Semmelweis University | Houston Methodist Hospital

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    Abstract
    OBJECTIVE:This survey was designed to evaluate exposure to sentinel mapping for cervical and endometrial cancers in addition to the quality and availability of surgical training in sentinel procedures around the world. Furthermore, we aimed to identify obstacles in surgical training in the sentinel procedure to support the adoption of this technique in clinical practice. METHODS:A 52-item survey was developed and computed using Qualtrics XM and SurveyMonkey software. The target population were members of the European Society of Gynaecological Oncology and the International Gynecological Cancer Society aged ≤40 years. The study invitation was disseminated within both organizations' database. The survey hyperlink was active between September and December 2022. Respondents using the same Internet Protocol address were excluded to avoid duplication of responses. Responses to <50% questions were excluded. RESULTS:Overall, 238 respondents joined the survey, and 182 (76.5%) provided answers that met the inclusion criteria. Sentinel mapping was implemented for a longer period and used more frequently in endometrial than in cervical carcinoma; 55% of the responders were initially trained in systematic lymph node dissection, and 22% were not yet trained in any lymph node staging. The main challenges in applying sentinel procedure for early-career gynecologic oncologists were no access to hands-on training (n = 22, 12.1%) and no clinical routine in performing systematic pelvic (n = 15, 8.2%) and para-aortic (n = 35, 19.2%) lymph node dissection in case of failed mapping. CONCLUSIONS:Although sentinel lymph node biopsy is integrated in cervical and endometrial cancer guidelines, a significant number of institutions do not implement this procedure in clinical routine, and 22% of early-career gynecologic oncologists are not trained in any type of surgical lymph node staging. Support for sentinel mapping in national guidelines and guided training opportunities are needed to apply this method globally.
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    【要点】：该研究通过全球调查评估了早期妇科肿瘤医生在宫颈和子宫内膜癌 sentinel 淋巴结映射方面的培训和实践情况，揭示了培训质量和可用性以及采用该技术的障碍。
    

    【方法】：使用Qualtrics XM和SurveyMonkey软件开发的52项调查，针对欧洲妇科肿瘤学会和国际妇科癌症学会40岁以下的会员进行。
    

    【实验】：调查在2022年9月至12月间进行，共有238名受访者参与，182名（76.5%）的答案符合纳入标准。结果显示，sentinel映射在子宫内膜癌中的应用时间更长，频率更高；大多数受访者初始培训为系统性淋巴结清扫，而有22%尚未接受任何类型的淋巴节点分期手术培训。主要挑战包括缺乏上手培训机会和临床常规。