Table 5. Provider attitudes and practice patterns for use of SLNM in gynecologic oncology.
| Provider attitudes | No. (%) | |
|---|---|---|
| Data supports use of sentinel lymph node evaluation in all endometrial cancer staging routinely regardless of histology | ||
| Strongly agree | 21 (10.7) | |
| Agree | 69 (34.8) | |
| Neutral/uncertain | 44 (22.2) | |
| Disagree | 51 (25.8) | |
| Strongly disagree | 12 (6.1) | |
| Data supports use of sentinel lymph node evaluation in all cervical cancer staging | ||
| Strongly agree | 19 (9.6) | |
| Agree | 49 (24.7) | |
| Neutral/uncertain | 74 (37.4) | |
| Disagree | 43 (21.7) | |
| Strongly disagree | 12 (6.1) | |
| Data supports use of sentinel lymph node evaluation in endometrial cancer staging in low risk histology endometrial cancer (FIGO1/2) | ||
| Strongly agree | 76 (38.4) | |
| Agree | 74 (37.4) | |
| Neutral/uncertain | 32 (16.2) | |
| Disagree | 9 (4.5) | |
| Strongly disagree | 5 (2.5) | |
| Improved technologies are needed before I would consider incorporating sentinel lymph node evaluation into my practice | ||
| Strongly agree | 7 (3.5) | |
| Agree | 20 (10.1) | |
| Neutral/uncertain | 33 (16.7) | |
| Disagree | 70 (35.4) | |
| Strongly disagree | 67 (33.8) | |
| Sentinel lymph node evaluation will impact fellows training and skill in performing full systemic lymphadenectomy | ||
| Strongly agree | 41 (20.7) | |
| Agree | 105 (53.0) | |
| Neutral/uncertain | 20 (10.1) | |
| Disagree | 29 (14.6) | |
| Strongly disagree | 2 (1.0) | |
| Patients with micro-metastatic disease (0.2–2.0mm) appreciated on sentinel lymph node evaluation for endometrial cancer should be assigned a stage as if they had node positive disease | ||
| Strongly Agree | 27 (13.6) | |
| Agree | 120 (60.6) | |
| Neutral/Uncertain | 45 (22.7) | |
| Disagree | 5 (2.5) | |
| Strongly Disagree | 0 | |
| Patients with micro-metastatic disease (0.2–2.0mm) appreciated on sentinel lymph node evaluation for endometrial cancer should be treated as if they had node positive disease | ||
| Strongly agree | 27 (13.6) | |
| Agree | 126 (63.6) | |
| Neutral/uncertain | 38 (19.2) | |
| Disagree | 5 (2.5) | |
| Strongly disagree | 0 | |
| Patients with ITCs appreciated on sentinel lymph node evaluation for endometrial cancer should be assigned a stage as if they had node positive disease | ||
| Strongly agree | 8 (4.0) | |
| Agree | 41 (20.7) | |
| Neutral/uncertain | 82 (41.4) | |
| Disagree | 59 (29.8) | |
| Strongly disagree | 6 (3.0) | |
| Patients with ITCs appreciated on sentinel lymph node evaluation for endometrial cancer should be treated as if they had node positive disease | ||
| Strongly agree | 6 (3.0) | |
| Agree | 36 (18.2) | |
| Neutral/uncertain | 91 (46.0) | |
| Disagree | 56 (28.3) | |
| Strongly disagree | 7 (3.5) | |
| Patients with micro-metastatic disease (0.2–2.0mm) appreciated on sentinel lymph node evaluation for cervical cancer should be treated as if they had node positive disease | ||
| Strongly agree | 33 (16.7) | |
| Agree | 108 (54.5) | |
| Neutral/uncertain | 47 (23.7) | |
| Disagree | 9 (4.5) | |
| Strongly disagree | 0 | |
| Patients with ITCs appreciated on sentinel lymph node evaluation for cervical cancer should be treated as if they had node positive disease | ||
| Strongly agree | 12 (6.1) | |
| Agree | 56 (28.3) | |
| Neutral/uncertain | 95 (48.0) | |
| Disagree | 32 (16.2) | |
| Strongly disagree | 1 (0.5) | |
| In patients with a positive sentinel lymph node (macro-metastatic disease) in endometrial cancer does your practice involve? | ||
| Proceeding to adjuvant treatment based on sentinel lymph node data | 108 (54.5) | |
| Returning to OR for completion lymphadenectomy in all cases | 4 (2.0) | |
| Returning to OR for completion lymphadenectomy in high risk disease (FIGO3, UCC, USC, CS) | 5 (2.5) | |
| Further imaging (PET, CT) to evaluate for additional metastatic disease | 70 (35.4) | |
| In patients with a positive sentinel lymph node (macro-metastatic disease) in cervical cancer does your practice involve? | ||
| Proceeding to adjuvant treatment based on sentinel lymph node data | 75 (37.9) | |
| Returning to OR for completion lymphadenectomy in all cases | 3 (1.5) | |
| Returning to OR for completion lymphadenectomy in high risk disease (FIGO3, UCC, USC, CS) | 2 (1.0) | |
| Further imaging (PET, CT) to evaluate for additional metastatic disease | 37 (18.7) | |
| Has the decision to proceed with SLNM changed any component of your pre-operative work-up (imaging, labs, etc)? | ||
| Yes | 14 (10.7) | |
| No | 122 (87.8) | |
CS, carcinosarcoma; CT, computed tomography; FIGO, International Federation of Gynecology and Obstetrics; ITC, isolated tumor cell; PET, positron emission tomography; SLNM, sentinel lymph node mapping; UCC, clear cell carcinoma; USC, uterine serous carcinoma.