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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
[European guidelines (ESMO-ESGO-ESTRO consensus conference) for the management of endometrial cancer]
Marcos Ballester1, Sofiane Bendifallah1, Emile Daraï1
1AP-HP, université Pierre-et-Marie-Curie, hôpital Tenon, service de gynécologie-obstétrique, 4, rue de la Chine, 75020 Paris, France.
Abstract:
Endometrial cancer (EC) is a major source of morbidity and mortality in women worldwide. In France, in 2015, EC was the first gynecological cancer in terms of incidence. Its prognosis is considered favorable because it is most often limited to the uterus at diagnosis. Nevertheless, it is a heterogeneous pathology and 5-year overall survival can vary from 92 % to 42 % in FIGO stage I depending on its histological characteristics. This great heterogeneity leads to important disparities in its surgical management as well as in indications for adjuvant therapies. A consensus conference including three different European learned societies (ESMO-ESGO-ESTRO) has recently established new recommendations in order to standardize its management. One of the main points is the emergence of a new subgroup of patients at risk of recurrence (high-intermediate risk group). Concerning nodal staging, indications are still somewhat blurred for intermediate and high-intermediate risk groups. The sentinel lymph node biopsy remains an experimental procedure in contrast with American guidelines. Concerning adjuvant therapies, the place of chemotherapy and its combination with external beam radiotherapy should be explored, especially for patients with high risk EC and for certain histological subtypes.
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