Controversy over sentinel lymph node detection in endometrial cancer

Area of Science:

• Gynecology
• Surgical Oncology
• Oncology

Background:

• Sentinel lymph node biopsy (SLNB) has become a key procedure in managing endometrial cancer.
• Its application has expanded from low-risk to intermediate- and high-risk cases over the past decade.
• However, significant controversies persist regarding patient selection, optimal tracer, and injection techniques.

Purpose of the Study:

• To provide a multidisciplinary review of the controversial issues surrounding SLNB in endometrial cancer.
• To analyze the advantages and disadvantages of various tracers used in SLNB.
• To establish a consensus on the application of SLNB in endometrial cancer management.

Main Methods:

• Review of current literature and clinical guidelines on SLNB in endometrial cancer.
• Multidisciplinary discussion of controversial aspects including patient stratification and tracer selection.
• Comparative analysis of radiotracers, hybrid tracers, and indocyanine green (ICG).

Main Results:

• No universal consensus exists on the ideal patient group for SLNB in endometrial cancer.
• Different tracers offer distinct benefits and drawbacks regarding detection rates, safety, and cost.
• Radiotracers, hybrid tracers, and ICG each present unique profiles in terms of efficacy and usability.

Conclusions:

• Further research and standardization are needed to optimize SLNB protocols for endometrial cancer.
• Shared decision-making and multidisciplinary input are crucial for refining SLNB application.
• Selecting the appropriate tracer is critical for maximizing the benefits of SLNB in endometrial cancer patients.