Evaluation of Different Risk Factors for Metastatic Sentinel Lymph Nodes in Endometrial Cancer

Area of Science:

• Gynecologic Oncology
• Pathology
• Surgical Oncology

Background:

• Sentinel lymph node (SLN) metastasis is a critical prognostic factor in early-stage endometrial carcinoma (EC).
• Identifying risk factors for SLN metastasis is crucial for accurate staging and treatment planning.

Purpose of the Study:

• To investigate demographic, clinical, and pathological factors associated with SLN metastasis in early-stage EC.
• To determine risk factors for different subtypes of SLN metastases, including macrometastasis (MAC), micrometastasis (MIC), and isolated tumor cells (ITCs).

Main Methods:

• Retrospective single-center study of 98 women with early-stage EC.
• Data collected from December 2015 to April 2024.
• Patients underwent total hysterectomy with salpingo-oophorectomy and SLN mapping using indocyanine green (ICG).

Main Results:

• Overall, 21.4% of patients had SLN metastasis.
• Identified risk factors for nodal involvement included age > 67 years, high-grade EC (G3), and myometrial invasion ≥ 50%.
• High-grade EC correlated with a higher probability of MAC, while low-grade EC (G1-G2) showed a strong relationship with LVM.

Conclusions:

• Age, high-grade EC, and deep myometrial invasion are significant risk factors for SLN metastasis in early-stage EC.
• Further research is needed to confirm the association of lymphovascular space invasion, histotype 2, and p53 mutations with SLN positivity.
• Low-grade EC is associated with low-volume metastasis, warranting further investigation.