Skip to main content
Top
Published in: Annals of Surgical Oncology 9/2016

01-09-2016 | Gynecologic Oncology

Quality of Care for Cervical and Endometrial Cancer Patients: The Impact of Different Techniques of Sentinel Lymph Node Mapping on Patient Satisfaction

Authors: Alessandro Buda, MD, Federica Elisei, MD, Sharon Palazzi, MD, Elena De Ponti, MD, Maurizio Arosio, MD, Francesca Vecchione, MD, Tiziana Dell’Anna, MD, Marco Cuzzocrea, MD, Beatrice Bussi, MD, Daniela Giuliani, MD, Giampaolo Di Martino, MD, Cinzia Crivellaro, MD

Published in: Annals of Surgical Oncology | Issue 9/2016

Login to get access

Abstract

Objectives

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.

Method

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.

Results

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).

Conclusions

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.
Literature
1.
go back to reference Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer. 1987;60:2035–41.CrossRefPubMed Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer. 1987;60:2035–41.CrossRefPubMed
2.
go back to reference Cibula D, Abu-Rustum NR, Dusek L, et al. Prognostic significance of low volume sentinel lymph node disease in early-stage cervical cancer. Gynecol Oncol. 2012;124:496–501.CrossRefPubMed Cibula D, Abu-Rustum NR, Dusek L, et al. Prognostic significance of low volume sentinel lymph node disease in early-stage cervical cancer. Gynecol Oncol. 2012;124:496–501.CrossRefPubMed
3.
go back to reference Khoury-Collado F, Murray MP, Hensley ML, et al. Sentinel lymph node mapping for endometrial cancer improves the detection of metastatic disease to regional lymph nodes. Gynecol Oncol. 2011;122:251–4.CrossRefPubMed Khoury-Collado F, Murray MP, Hensley ML, et al. Sentinel lymph node mapping for endometrial cancer improves the detection of metastatic disease to regional lymph nodes. Gynecol Oncol. 2011;122:251–4.CrossRefPubMed
4.
go back to reference Ballester M, Naoura I, Chéreau E, et al. Sentinel node biopsy upstages patients with presumed low- and intermediate-risk endometrial cancer: results of a multicenter study. Ann Surg Oncol. 2013;20:407–12.CrossRefPubMed Ballester M, Naoura I, Chéreau E, et al. Sentinel node biopsy upstages patients with presumed low- and intermediate-risk endometrial cancer: results of a multicenter study. Ann Surg Oncol. 2013;20:407–12.CrossRefPubMed
5.
go back to reference Cormier B, Diaz JP, Shih K, et al. Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecol Oncol. 2011;122:275–80.CrossRefPubMed Cormier B, Diaz JP, Shih K, et al. Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecol Oncol. 2011;122:275–80.CrossRefPubMed
6.
go back to reference St Clair CM, Ericksson AG, Ducie JA, et al. Low-volume lymph node metastasis discovered during sentinel lymph node mapping for endometrial cancer. Ann Surg Oncol. 2016;23(5):1653–9.CrossRefPubMed St Clair CM, Ericksson AG, Ducie JA, et al. Low-volume lymph node metastasis discovered during sentinel lymph node mapping for endometrial cancer. Ann Surg Oncol. 2016;23(5):1653–9.CrossRefPubMed
7.
go back to reference Touhami O, Trinh XB, Gregoire J, et al. Predictors of non-sentinel lymph node (non-SLN) metastasis in patients with sentinel lymph node (SLN) metastasis in endometrial cancer. Gynecol Oncol. 2015;138(1):41–5.CrossRefPubMed Touhami O, Trinh XB, Gregoire J, et al. Predictors of non-sentinel lymph node (non-SLN) metastasis in patients with sentinel lymph node (SLN) metastasis in endometrial cancer. Gynecol Oncol. 2015;138(1):41–5.CrossRefPubMed
8.
go back to reference Burke TW, Levenback C, Tornos C, et al. Intraabdominal lymphatic mapping to direct pelvic and aortic lymphadenectomy in women with high risk endometrial cancer: results of a pilot study. Gynecol Oncol. 1996;62:169–73.CrossRefPubMed Burke TW, Levenback C, Tornos C, et al. Intraabdominal lymphatic mapping to direct pelvic and aortic lymphadenectomy in women with high risk endometrial cancer: results of a pilot study. Gynecol Oncol. 1996;62:169–73.CrossRefPubMed
9.
go back to reference How J, Gotlieb WH, Press JZ, et al. Comparing indocyanine green, technetium, and blue dye for sentinel lymph node mapping in endometrial cancer. Gynecol Oncol. 2015;137(3):436–42.CrossRefPubMed How J, Gotlieb WH, Press JZ, et al. Comparing indocyanine green, technetium, and blue dye for sentinel lymph node mapping in endometrial cancer. Gynecol Oncol. 2015;137(3):436–42.CrossRefPubMed
10.
go back to reference Jewell EL, Huang JJ, Abu-Rustum NR, et al. Detection of sentinel lymph nodes in minimally invasive surgery using indocyanine green and near-infrared fluorescence imaging for uterine and cervical malignancies. Gynecol Oncol. 2014;133(2):274–77.CrossRefPubMed Jewell EL, Huang JJ, Abu-Rustum NR, et al. Detection of sentinel lymph nodes in minimally invasive surgery using indocyanine green and near-infrared fluorescence imaging for uterine and cervical malignancies. Gynecol Oncol. 2014;133(2):274–77.CrossRefPubMed
11.
go back to reference Avery KN, Metcalfe C, Nicklin J, et al. Satisfaction with care: an independent outcome measure in surgical oncology. Ann Surg Oncol. 2006;13:817–22.CrossRefPubMed Avery KN, Metcalfe C, Nicklin J, et al. Satisfaction with care: an independent outcome measure in surgical oncology. Ann Surg Oncol. 2006;13:817–22.CrossRefPubMed
12.
go back to reference Tomlinson SJ, Ko CY. Patient satisfaction: an increasingly important measure of quality. Ann Surg Oncol. 2006;13(6):609–20.CrossRef Tomlinson SJ, Ko CY. Patient satisfaction: an increasingly important measure of quality. Ann Surg Oncol. 2006;13(6):609–20.CrossRef
13.
go back to reference Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med 2001;52(4):609–20.CrossRefPubMed Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med 2001;52(4):609–20.CrossRefPubMed
14.
go back to reference Bredart A, Bottomley A, Blazeby JM, et al. An international prospective study of the EORTC cancer in-patient satisfaction with care measure (EORTC IN-PATSAT32). Eur J Cancer. 2005;41:2120–31.CrossRefPubMed Bredart A, Bottomley A, Blazeby JM, et al. An international prospective study of the EORTC cancer in-patient satisfaction with care measure (EORTC IN-PATSAT32). Eur J Cancer. 2005;41:2120–31.CrossRefPubMed
15.
go back to reference Buda A, Elisei F, Arosio M, et al. Integration of hybrid single-photon emission computed tomography/computed tomography in the preoperative assessment of sentinel node in patients with cervical and endometrial cancer: our experience and literature review. Int J Gynecol Cancer. 2012;22:830–5.CrossRefPubMed Buda A, Elisei F, Arosio M, et al. Integration of hybrid single-photon emission computed tomography/computed tomography in the preoperative assessment of sentinel node in patients with cervical and endometrial cancer: our experience and literature review. Int J Gynecol Cancer. 2012;22:830–5.CrossRefPubMed
16.
go back to reference Blazeby J, Cull M, Groenvold M, et al. Guidelines for developing quality of life questionnaires. 3rd ed. Brussels: EORTC Publications; 2001. ISBN 2-930064-24-2. Blazeby J, Cull M, Groenvold M, et al. Guidelines for developing quality of life questionnaires. 3rd ed. Brussels: EORTC Publications; 2001. ISBN 2-930064-24-2.
17.
go back to reference Todo Y, Kato H, Okamoto K, et al. Isolated tumor cells and micrometastases in regional lymph nodes in stage I to II endometrial cancer. J Gynecol Oncol. 2016;27(1):e1.CrossRefPubMed Todo Y, Kato H, Okamoto K, et al. Isolated tumor cells and micrometastases in regional lymph nodes in stage I to II endometrial cancer. J Gynecol Oncol. 2016;27(1):e1.CrossRefPubMed
18.
go back to reference NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Version 2.2015. Fort Washington: National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Version 2.2015. Fort Washington: National Comprehensive Cancer Network.
19.
go back to reference Koh WJ, Greer BE, Abu-Rustum NR, et al. Cervical cancer, version 2.2015. Featured updates to the NCCN guidelines. JNCCN. 2015;13(4):395–404.PubMed Koh WJ, Greer BE, Abu-Rustum NR, et al. Cervical cancer, version 2.2015. Featured updates to the NCCN guidelines. JNCCN. 2015;13(4):395–404.PubMed
20.
go back to reference Barlin JN, Khoury-Collado F, Kim CH, et al. The importance of applying a sentinel lymph node algorithm in endometrial cancer staging: beyond removal of blue nodes. Gynecol Oncol. 2012;125:531–35.CrossRefPubMed Barlin JN, Khoury-Collado F, Kim CH, et al. The importance of applying a sentinel lymph node algorithm in endometrial cancer staging: beyond removal of blue nodes. Gynecol Oncol. 2012;125:531–35.CrossRefPubMed
21.
go back to reference Eriksson AG, Ducie J, Ali N, et al. Comparison of a sentinel lymph node and a selective lymphadenectomy algorithm in patients with endometriod endometrial carcinoma and limited myometrial invasion. Gynecol Oncol. 2016;140(3):394–9.CrossRef Eriksson AG, Ducie J, Ali N, et al. Comparison of a sentinel lymph node and a selective lymphadenectomy algorithm in patients with endometriod endometrial carcinoma and limited myometrial invasion. Gynecol Oncol. 2016;140(3):394–9.CrossRef
22.
go back to reference Buda A, Crivellaro C, Elisei F, et al. Impact of indocyanine green (ICG) for sentinel lymph node mapping in early stage endometrial and cervical cancer: comparison with conventional radiotracer 99mTC and/or blue dye. Ann Surg Oncol. 2015. doi: 10.1245/s10434-015-5022-1.PubMedPubMedCentral Buda A, Crivellaro C, Elisei F, et al. Impact of indocyanine green (ICG) for sentinel lymph node mapping in early stage endometrial and cervical cancer: comparison with conventional radiotracer 99mTC and/or blue dye. Ann Surg Oncol. 2015. doi: 10.​1245/​s10434-015-5022-1.PubMedPubMedCentral
23.
go back to reference Buda A, Cuzzocrea M, Montanelli L, et al. Evaluation of patient satisfaction using the EORTC IN-PATSAT32 questionnaire and surgical outcomes in single-port surgery for benign adnexal disease: observational comparison with traditional laparoscopy. Diagn Ther Endosc. 2013;2013:578392.CrossRefPubMedPubMedCentral Buda A, Cuzzocrea M, Montanelli L, et al. Evaluation of patient satisfaction using the EORTC IN-PATSAT32 questionnaire and surgical outcomes in single-port surgery for benign adnexal disease: observational comparison with traditional laparoscopy. Diagn Ther Endosc. 2013;2013:578392.CrossRefPubMedPubMedCentral
24.
go back to reference Bredart A, Razavi D, Robertson C, et al. Timing of patient satisfaction assessment: effect on questionnaire acceptability, completeness of data, reliability and variability of scores. Patient Educ Couns. 2002;46:131–36.CrossRefPubMed Bredart A, Razavi D, Robertson C, et al. Timing of patient satisfaction assessment: effect on questionnaire acceptability, completeness of data, reliability and variability of scores. Patient Educ Couns. 2002;46:131–36.CrossRefPubMed
25.
go back to reference Pompili C, Tiberi M, Salati M, et al. Patient satisfaction with health-care professionals and structure is not affected by longer hospital stay and complications after lung resection: a case-matched analysis. Interact Cardiovasc Thorac Surg. 2015;20(2):236–41.CrossRefPubMed Pompili C, Tiberi M, Salati M, et al. Patient satisfaction with health-care professionals and structure is not affected by longer hospital stay and complications after lung resection: a case-matched analysis. Interact Cardiovasc Thorac Surg. 2015;20(2):236–41.CrossRefPubMed
26.
go back to reference Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276(8):637–9.CrossRefPubMed Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276(8):637–9.CrossRefPubMed
Metadata
Title
Quality of Care for Cervical and Endometrial Cancer Patients: The Impact of Different Techniques of Sentinel Lymph Node Mapping on Patient Satisfaction
Authors
Alessandro Buda, MD
Federica Elisei, MD
Sharon Palazzi, MD
Elena De Ponti, MD
Maurizio Arosio, MD
Francesca Vecchione, MD
Tiziana Dell’Anna, MD
Marco Cuzzocrea, MD
Beatrice Bussi, MD
Daniela Giuliani, MD
Giampaolo Di Martino, MD
Cinzia Crivellaro, MD
Publication date
01-09-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5233-0

Other articles of this Issue 9/2016

Annals of Surgical Oncology 9/2016 Go to the issue