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Sentinel node mapping decreases the risk of failed detection of isolated positive para-aortic lymph node in endometrial cancer

  • 0Department of Gynecologic Oncology, A.C.Camargo Cancer Center, São Paulo, Brazil.
International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society +

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April 14, 2025

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April 14, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Sentinel lymph node (SLN) mapping in endometrial cancer may reduce the risk of isolated para-aortic lymph node metastasis. This SLN protocol accurately predicts lymph node status, offering a potential improvement over traditional lymphadenectomy.

Area Of Science

  • Gynecologic Oncology
  • Surgical Pathology
  • Cancer Metastasis Research

Background

  • Isolated positive para-aortic lymph node metastasis is an uncommon finding in endometrial cancer, occurring in 1% to 3% of cases.
  • Accurate staging of lymph node involvement is crucial for effective endometrial cancer treatment and prognosis.

Purpose Of The Study

  • To evaluate the impact of sentinel lymph node (SLN) mapping on the incidence of isolated positive para-aortic lymph node metastasis in endometrial cancer patients.
  • To compare the effectiveness of SLN mapping versus traditional lymphadenectomy in identifying para-aortic lymph node involvement.

Main Methods

  • Retrospective analysis of 426 patients undergoing SLN mapping (2013-2021) compared to 209 patients undergoing systematic lymphadenectomy (LND) (2007-2015).
  • Inclusion of isolated para-aortic lymph node metastasis recurrences in the SLN group analysis.
  • Evaluation of SLN mapping accuracy and identification of SLNs outside the pelvis.

Main Results

  • The SLN group showed a significantly lower rate of isolated para-aortic lymph node metastasis (0.5%) compared to the LND group (3.3%) (p=0.004).
  • SLN mapping identified positive lymph nodes outside the pelvis in 3.3% of cases, including one in the para-aortic region.
  • The SLN group had higher rates of minimally invasive surgery and lymphovascular space invasion, but fewer high-grade tumors and deep myometrial invasion.

Conclusions

  • Sentinel lymph node (SLN) mapping accurately predicts lymph node status in endometrial cancer.
  • The SLN protocol may decrease the risk of failing to identify isolated para-aortic lymph node metastasis compared to systematic lymphadenectomy.

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