Archives of Gynecology and Obstetrics

, Volume 300, Issue 1, pp 191–199 | Cite as

A GCIG international survey: clinical practice patterns of sentinel lymph node biopsies in cervical cancer

  • G. F. VercellinoEmail author
  • E. Erdemoglu
  • P. Lichtenberg
  • M. Z. Muallem
  • R. Richter
  • N. R. Abu-Rustum
  • M. Plante
  • F. Lécuru
  • S. Greggi
  • B. J. Monk
  • S. Sagae
  • C. Denkert
  • M. Keller
  • M. Alhakeem
  • M. Hellriegel
  • A. M. Dückelmann
  • V. Chiantera
  • Jalid SehouliEmail author
Gynecologic Oncology



To evaluate the practice patterns among centers and physicians worldwide regarding sentinel lymph node biopsies (SLNB) in cervical cancer (CC) patients.


A validated 35-item questionnaire regarding SLNB in CC supported by the Gynecologic Cancer Intergroup (GCIG), and sponsored by the North-Eastern German Society of Gynaecologic–Oncology (NOGGO) was sent to all major gynecological cancer societies across the globe for further distribution from October 2015 and continued for a period of 7 months.


One hundred and sixty-one institutions from around the world participated. One hundred and six (66%) of the participants were from university centers and 111 (69%) were gynecologic oncologists. One hundred and fifty-two (97%) performed lymphadenectomy (LNE) and 147 (94%) did so systematically; 97 (60%) used SLNB, due to lower morbidity (73%), reliability (55%) and time-saving (27%). In cases of positive SLNB (pN+), 39% of respondents stopped the operation and sent the patient for chemoradiation (CRT), 45% completed pelvic and paraaortic LNE, whereas 26% went on to perform a radical hysterectomy (RH) and systematic pelvic and paraaortic LNE. In case of negative SLNB (pN0), 39% of institutions still performed a systematic pelvic and paraaortic LNE.


In this survey worldwide, SLNB adoption is an encouraging 60%, yet ample differences exist regarding strategy, and to a lower extent the techniques used. Lack of experience is the most common reason SLNB is not performed. Efforts to increase surgical education on SLNB technique and multicenter prospective trials providing evidence-based guidelines are warranted.


International survey Sentinel lymph node biopsy Cervical cancer 


Author contributions

GFV: idea, questionnaire editing, questionnaire editing revision, data collection, manuscript editing, table editing, manuscript revision; EE: data collection, manuscript revision; PL: data collection; MZM: data collection; RR: data collection; NAR: data collection, manuscript revision; MP: data collection, manuscript revision; FL: data collection, manuscript revision; SG: data collection; BJM: data collection, manuscript revision; SS: data collection, manuscript revision; MA: data collection; CD: data collection; MK: questionnaire and reminder posting, contact with centers, manuscript revision; MH: data collection; AMD: data collection; VC: data collection, manuscript revision; JS: questionnaire editing revision, data collection, manuscript revision.

Compliance with ethical standards

Conflict of interest

No actual or potential conflict of interest in relation to this article exists. Specifically, Bradley Monk has consulted for Roche Inc, Genmab and Advaxis; other authors declare no conflicts of interest. Thanks to: Ione und Costas Tziouvas for their very precious help editing the article.

Supplementary material

404_2019_5164_MOESM1_ESM.docx (247 kb)
Supplementary material 1 (DOCX 246 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • G. F. Vercellino
    • 1
    • 14
    Email author
  • E. Erdemoglu
    • 2
  • P. Lichtenberg
    • 1
  • M. Z. Muallem
    • 1
  • R. Richter
    • 1
  • N. R. Abu-Rustum
    • 3
  • M. Plante
    • 4
  • F. Lécuru
    • 5
    • 6
  • S. Greggi
    • 7
  • B. J. Monk
    • 8
  • S. Sagae
    • 9
  • C. Denkert
    • 11
  • M. Keller
    • 1
  • M. Alhakeem
    • 1
    • 10
  • M. Hellriegel
    • 12
  • A. M. Dückelmann
    • 1
  • V. Chiantera
    • 13
  • Jalid Sehouli
    • 1
    • 15
    Email author
  1. 1.Department of Gynecology With Center for Oncological SurgeryCharité UniverstitätmedizinBerlinGermany
  2. 2.Department of Gynecologic OncologySuleyman Demirel UniversityIspartaTurkey
  3. 3.Gynecology Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Division of Gynecologic OncologyCentre Hospitalier Universitaire de Laval QuébecQuebecCanada
  5. 5.Department of Gynecologic Oncologic and Breast SurgeryHôpital Européen Georges Pompidou (HEGP)ParisFrance
  6. 6.Université Paris DescartesParisFrance
  7. 7.Gynecologic Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori di NapoliNaplesItaly
  8. 8.University of Arizona Cancer Center-Phoenix, Creighton University School of Medicine at St Joseph’s Hospital and Medical CenterPhoenixUSA
  9. 9.Department of Gynecologic OncologySapporo West Kojinkai ClinicSapporoJapan
  10. 10.Obstetrics and Gynaecology Department, College of MedicineKing Saud UniversityRiyadhSaudi Arabia
  11. 11.Department of PathologyCharité UniverstitätmedizinBerlinGermany
  12. 12.Clinic for Obstetrics and GynecologyUMG UniversitätmedizinGöttingenGermany
  13. 13.Department of Gynecologic OncologyUniversity of PalermoPalermoItaly
  14. 14.UMG Universität Medizin GöttingenGöttingenGermany
  15. 15.ESGO Center of Excellence Ovarian Cancer Surgery, ESGO Accredited European Training Centre in Gynaecological Oncology, Charité Comprehensive Cancer Center (CCCC), Universitätsmedizin Berlin Charité/Medical University of BerlinBerlinGermany

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