ArticleInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society2024
Consensus on surgical technique for sentinel lymph node dissection in cervical cancer.
Article in International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
- Minimally invasive simple hysterectomy in low-risk cervical cancer: a single-arm trial with stopping rules (ENGOT-cx23/MITO/LASH trial).International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2025Trial
- Sentinel lymph node and operative outcomes in patients with endometrial cancer and a BMI ≥ 50: the SLOPE-50 study.Journal of robotic surgery · 2026Article
- Microscopic assessment of lymph node status in gynecological malignancies using full-field optical coherence tomography.Scientific reports · 2025Article
- Diagnostic Value of Superparamagnetic Iron Oxide Nanoparticles as a Tracer for Sentinel Lymph Node Mapping in Early-Stage Cervical Cancer: The Preliminary Clinical Experience.Journal of functional biomaterials · 2025Article
- Article
- Prediction of lymph node metastasis in cervical cancer patients using AdaBoost machine learning model: analysis of risk factors.American journal of cancer research · 2025Article
- Mapping the immunological landscape and emerging immunotherapeutic strategies in cervical cancer: a comprehensive review.Frontiers in oncology · 2025Review
- Combining multimodal diffusion-weighted imaging and morphological parameters for detecting lymph node metastasis in cervical cancer.Abdominal radiology (New York) · 2024Article
- Impact of Indocyanine Green Dose on Sentinel Lymph Node Mapping in Cervical Cancer: A Systematic Review.Cancers · 2024Review
- Sentinel Lymph Node Mapping by Retroperitoneal vNOTES for Uterus-Confined Malignancies: A Standardized 10-Step Approach.Cancers · 2024Article
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Authors and funding
32 authors at 20 institutions in 13 countries.
Funding
Abstract
objectiveThe purpose of this study was to establish a consensus on the surgical technique for sentinel lymph node (SLN) dissection in cervical cancer.
methodsA 26 question survey was emailed to international expert gynecological oncology surgeons. A two-step modified Delphi method was used to establish consensus. After a first round of online survey, the questions were amended and a second round, along with semistructured interviews was performed. Consensus was defined using a 70% cut-off for agreement.
resultsTwenty-five of 38 (65.8%) experts responded to the first and second rounds of the online survey. Agreement ≥70% was reached for 13 (50.0%) questions in the first round and for 15 (57.7%) in the final round. Consensus agreement identified 15 recommended, three optional, and five not recommended steps. Experts agreed on the following recommended procedures: use of indocyanine green as a tracer; superficial (with or without deep) injection at 3 and 9 o'clock; injection at the margins of uninvolved mucosa avoiding vaginal fornices; grasping the cervix with forceps only in part of the cervix is free of tumor; use of a minimally invasive approach for SLN biopsy in the case of simple trachelectomy/conization; identification of the ureter, obliterated umbilical artery, and external iliac vessels before SLN excision; commencing the dissection at the level of the uterine artery and continuing laterally; and completing dissection in one hemi-pelvis before proceeding to the contralateral side. Consensus was also reached in recommending against injection at 6 and 12 o'clock, and injection directly into the tumor in cases of the tumor completely replacing the cervix; against removal of nodes through port without protective maneuvers; absence of an ultrastaging protocol; and against modifying tracer concentration at the time of re-injection after mapping failure.
conclusionRecommended, optional, and not recommended steps of SLN dissection in cervical cancer have been identified based on consensus among international experts. These represent a surgical guide that may be used by surgeons in clinical trials and for quality assurance in routine practice.
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