Quality of Care for Cervical and Endometrial Cancer Patients: The Impact of Different Techniques of Sentinel Lymph Node Mapping on Patient Satisfaction.
The purpose of this study was to assess the quality of care in patients who underwent sentinel lymph node (SLN) mapping for endometrial and cervical cancer staging, and evaluate the impact of different techniques on patient satisfaction, i.e. radiotracer Tc99m versus indocyanine green (ICG) or methylene blue injection.



Women with preoperative stage I endometrial cancer or stage I (1A2-1B1) cervical cancer who underwent surgical staging, including SLN mapping, were considered for this study. Patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer IN-PATSAT32 questionnaire. Women were classified into two groups according to the different nodal mapping techniques: intracervical preoperative injection of Tc99m nanocolloid + intraoperative blue dye (Group 1) versus intraoperative cervical injection of ICG or blue dye (Group 2). Differences in patient satisfaction scores between the groups were analyzed.



Of the 178 eligible women, 143 were included in the study (endometrial cancer n = 106, cervical cancer n = 37): 57 underwent SLN mapping with Tc99m and blue dye (Group 1), and 86 women were mapped intraoperatively with blue dye alone or ICG (Group 2). Analysis of IN-PATSAT32 questionnaire scores showed a higher patient satisfaction score for patients in Group 2 (p = 0.001), which was independent of the physician and surgical outcomes evaluated. The scores were statistically better for Group 2, and also in rating doctors (p = 0.0001), nurses (p = 0.006), and care and services organizations (p = 0.001).



Cervical and endometrial cancer patients who underwent SLN mapping by ICG or blue dye perceived a better quality of care when compared with those patients who underwent the combined radiocolloid and blue dye technique.
Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy. ginoncmonza@gmail.com.|University of Milano-Bicocca, Monza, Italy. ginoncmonza@gmail.com.
Alessandro
A
Buda
Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.
Federica
F
Elisei
University of Milano-Bicocca, Monza, Italy.
Sharon
S
Palazzi
Department of Medical Physics, San Gerardo Hospital, Monza, Italy.
Elena
E
De Ponti
Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.
Maurizio
M
Arosio
Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.
Francesca
F
Vecchione
Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.
Tiziana
T
Dell'Anna
University of Milano-Bicocca, Monza, Italy.
Marco
M
Cuzzocrea
University of Milano-Bicocca, Monza, Italy.
Beatrice
B
Bussi
University of Milano-Bicocca, Monza, Italy.
Daniela
D
Giuliani
University of Milano-Bicocca, Monza, Italy.
Giampaolo
G
Di Martino
Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.|Technomed Foundation, University of Milano-Bicocca, Monza, Italy.
Cinzia
C
Crivellaro
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008197:Lymph Node Excision; D008751:Methylene Blue; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011787:Quality of Health Care; D019275:Radiopharmaceuticals; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D011795:Surveys and Questionnaires; D013668:Technetium Tc 99m Aggregated Albumin; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid; D007208:Indocyanine Green; D008751:Methylene Blue