Lymph node evaluation in high-risk early stage endometrial cancer: A multi-institutional retrospective analysis comparing the sentinel lymph node (SLN) algorithm and SLN with selective lymphadenectomy

Gynecol Oncol. 2018 Aug;150(2):261-266. doi: 10.1016/j.ygyno.2018.06.003. Epub 2018 Jun 7.


Objective: The aim of this study was to determine the impact of the sentinel lymph node mapping algorithm (SLN-A) on the staging in high-risk endometrial cancer (EC) compared to SLN plus selective lymphadenectomy (S-LND).

Methods: We retrospectively analyzed the database from a multicenter collaboration that included women with high risk features who underwent primary surgical staging.

Results: One-hundred and seventy-one women were identified (171), 66 in the SLN-A and 105 in the S-LND group, respectively. Pelvic LD was performed on 115 patients (67.2%) and aortic dissection was performed in 54/105 of the women in the S-LND group (51%). The 5-year comparison did not show a significant difference in the strategy adopted for nodal staging, regarding disease-free survival (DFS) [HR: 0.82; 95% CI 0.53-1.28; p = 0.390].

Conclusions: In this study focusing on women with EC in the HR groups, we did not find a difference in the 5-year DFS when comparing the SLN-A strategy with S-LND. The SLN strategy did not seem to compromise the prognosis of patients with a higher risk of recurrence.

Keywords: High-risk endometrial cancer; Nodal staging; Selective lymphadenectomy; Sentinel node mapping.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Lymph Node Excision / methods
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Sentinel Lymph Node / pathology*
  • Sentinel Lymph Node / surgery*
  • Sentinel Lymph Node Biopsy / methods