title: Application of sentinel lymph node dissection in gynecological cancers: results of a survey among German hospitals.
abstract: OBJECTIVE
  Evaluating the application of the sentinel lymph node dissection (SLND) in gynecological cancers among German hospitals.
  
  
  METHODS
  Between March and June 2016 an online questionnaire on SLND in gynecologic cancers was sent by email to all German gynecologic cancer centers, all university hospitals and general hospitals for which an email address was available. The survey contained 61 questions regarding the SLND in vulvar, cervical, endometrial and ovarian cancer.
  
  
  RESULTS
  In total, 63 clinics, including 13 (20.6%) university hospitals, 28 (44.4%) hospitals offering maximum care and 22 (34.9%) general hospitals, responded to the questionnaire. Most clinics (46/63, 73%) performed SLND in vulvar cancer with a median amount of 7.8 (range 1-43) SLND per year. 56.5% of the clinics included patients according to the German national guidelines and performed ultrastaging of negative SLN. Furthermore, 18/63 (28.5%) of the responding clinics applied SLND in cervical cancer including 7 (77.8%) centers which conducted isolated SLND without radical pelvic lymph node dissection (LND). Preoperative imaging with planar lymphoscintigraphy (LSG) was applied in 12/18 (66.7%) of the clinics. SLND in endometrial cancer was reported by 4/63 (6.4%) hospitals. Three of them (75%) regularly performed a subsequent radical pelvic LND. One clinic (1.5%) reported SLND in ovarian cancer in combination with radical LND.
  
  
  CONCLUSIONS
  Especially in vulvar and cervical cancer, isolated SLND appears to be partially implemented in the routine surgical treatment. However, this survey illustrates a wide heterogeneity regarding inclusion criteria and application of the SLND approach.
authors.affiliation: Department of Obstetrics and Gynecology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. klapdor.ruediger@mh-hannover.de.
authors.forename: Rüdiger
authors.identifier: http://orcid.org/0000-0002-0117-4366
authors.initials: R
authors.lastname: Klapdor
authors.affiliation: Department of Obstetrics and Gynecology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Hertel
authors.affiliation: Department of Obstetrics and Gynecology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Soergel
authors.affiliation: Department of Obstetrics and Gynecology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Jentschke
authors.affiliation: Department of Obstetrics and Gynecology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hillemanns
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D061305:Lymphoscintigraphy; D000071036:Sentinel Lymph Node / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Cervical cancer; Gynecologic cancer; Lymph node dissection; Sentinel; Vulvar cancer