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Defining "enlarged" sentinel lymph nodes in the setting of endometrial cancer: What is the size cut-off?

  • 0Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, The James Cancer Hospital and Solove Research Institute, Columbus, OH, USA.
Gynecologic Oncology +

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February 19, 2025

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February 19, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Sentinel lymph node (SLN) size is similar in both negative and positive cases for endometrial cancer staging. Relying solely on size for intra-operative assessment is not recommended for detecting metastasis.

Area Of Science

  • Gynecologic Oncology
  • Surgical Pathology
  • Cancer Staging

Background

  • Sentinel lymph node (SLN) mapping is standard for endometrial cancer staging.
  • No established size criteria exist for intra-operative assessment of lymph nodes.
  • This study evaluated SLN size in relation to metastasis.

Purpose Of The Study

  • To assess and compare the sizes of negative (benign) and positive (metastatic) SLNs in endometrial cancer patients.
  • To determine if SLN size can reliably predict metastasis during surgical staging.

Main Methods

  • Retrospective review of 597 endometrial cancer patients from 2017-2020.
  • SLNs categorized as negative or positive based on pathology.
  • Largest diameter (cm) from surgical pathology reports used for size measurement.

Main Results

  • Median size of negative SLNs was 2.0 cm; positive SLNs was 2.1 cm.
  • Lymph nodes ≥2 cm were 67% sensitive and 49% specific for metastasis.
  • Age <50 and BMI ≥30 associated with larger lymph node size.

Conclusions

  • Negative and positive SLNs exhibit similar sizes in endometrial cancer.
  • SLN size is an unreliable predictor of metastasis.
  • Intra-operative size assessment alone should not guide lymph node removal.

Keywords: