#756 Consensus on surgical steps for sentinel lymph node dissection in cervical cancer

Abstract

<h3>Introduction/Background</h3> Sentinel lymph node (SLN) biopsy is routinely performed in early cervical cancer. Variation in surgical techniques impacts diagnostic accuracy and poses barriers to the comparison of outcomes across institutions. Standardization of technique and quality assessment tools are critical. The purpose of this study was to establish a consensus on the surgical steps of SLN dissection in cervical cancer. <h3>Methodology</h3> A survey containing 26 questions 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 semi-structured interviews was performed. Consensus was defined if a step was considered recommended, optional or not recommended using a 70% cut-off for agreement. <h3>Results</h3> Twenty-five of 38 (65.8%) experts responded to the online survey. Agreement &gt;70% was reached in 13 (52.0%) questions at first round and 15 (60.0%) at final round. Figure 1 shows the consensus agreement which identified 15 recommended, 3 optional and 5 not recommended steps. Agreement of 70% was not reached for ICG concentration, total volume of tracer injected, timing of injection, approach to SLN in case of radical hysterectomy or radical trachelectomy, exposure of retroperitoneal spaces before dissecting SLN, how to approach multiple SLNs, avoid empty packets, or how to retrieve SLN. In 32% of cases, experts suggested the use of frozen section to confirm nodal tissue and exclude metastasis. <h3>Conclusion</h3> Recommended, optional and not recommended steps of SLN dissection in cervical cancer have been identified based on consensus among international experts. An operation guide may be used by surgeons in clinical trials and for quality assurance in routine clinical care. <h3>Disclosures</h3> None