Objectives Sentinel lymph node (SLN) mappinghas been proven to accurately stage endometrial cancer (EC). However, there is a lack of studies comparing the incidence of complications between different lymph node approaches in EC. Our objective is to define the complication rates of SLN biopsy in EC patients.
Methods We retrospectively analyzed all patients with EC surgically treated at Barretos Cancer Hospital between April 2013 and March 2018. We evaluated intraoperative complications and 30-day complications using the Memorial Sloan Lettering Cancer Center’s Surgical Secondary Events Grading System, separating the patients into four groups: hysterectomy (HT); hysterectomy plus pelvic lymphadenectomy, with or without para-aortic dissection (HT+LND); hysterectomy plus sentinel biopsy (HT+SLN); and hysterectomy plus lymphadenectomy and sentinel biopsy (HT+SLN+LND).
Results As compared with the HT group, the HT+SLN group did not show any increased risk of complications in terms of intraoperative injury (0vs1; p=1.0) and 30-day complications (8vs7; p=0.782).The HT+LND group had an increased surgical time (370 min, p<0.001), greater intraoperative blood loss (100cc, p<0.001), and a higher incidence of injury during surgery (7%, p=0.005) and any 30-day complication (38.2%, p=0.002) as compared with HT+SLN. Performing LND was associated with a greater risk of 30-day complications (hazard ratio [HR]:14.25; 95% confidence interval [CI]:1.85–19.63) and intraoperative injury (HR:3.11; 95% CI:1.62–5.98).
Conclusions SLN mapping does not increase morbidity in the surgical treatment of EC patients, and compared with comprehensive lymphadenectomy, it has a lower risk of complications. Our findings support the use of the SLN algorithm in EC patients.
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