Related Experiment Video
Updated: Jun 12, 2025
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Simple perinephric adipose tissue measurement for prediction of failed sentinel lymph node mapping in endometrial
Lina Salman1, Paulina Cybulska2, Ryley Fowler3
1University of Western Ontario, London Health Sciences Centre, Department of Obstetrics and Gynecology, London, ON, Canada.
Objective:
We aimed to evaluate whether pre-operative average perinephric fat is associated with sentinel lymph node (SLN) mapping, peri-operative complications, and survival in endometrial cancer.
Methods:
This was a retrospective cohort study of endometrial cancer patients who underwent surgical staging with SLN mapping between 2015 and 2021. Average perinephric fat was measured on axial sections of pre-operative computed tomography scans. Baseline characteristics and average perinephric fat measurements were compared between patients with successful mapping and those with bilateral failed mapping. We also compared peri-operative complications between patients with high and low average perinephric fat.
Results:
Of the 297 participants included, 274 (92%) had at least unilateral successful SLN mapping, while 23 (8%) had bilateral failed SLN mapping. Median body mass index (34.7 vs 29.8 kg/m2, p = .01) and average perinephric fat (1.5 vs 1.0 cm, p = .02) were significantly higher among patients with failed mapping. In univariate logistic regression, body mass index (OR 1.07, 95% CI 1.03 to 1.12, p = .001) and average perinephric fat (OR 1.43, 95% CI 1.13 to 1.80, p = .003) were associated with failed mapping. Using receiver operating characteristic curve analysis, a cut-off of 2.2 cm for average perinephric fat was a significant predictor of failed mapping (OR 7.62, 95% CI 2.85 to 20.3, p < .001). There was no significant difference in intra-operative (4% vs 3%) or post-operative complications (19% vs 14%) between those with average perinephric fat ≥ 2.2 cm and <2.2 cm (p > .05).
Conclusions:
Increased average perinephric fat is associated with a higher risk of failed SLN mapping in endometrial cancer, without an associated increase in peri-operative complications. Incorporating this simple measurement into clinical practice may add value in identifying and counseling individuals at higher risk for failed mapping.
