Objectives To assess survival among patients with uterine serous carcinoma (USC) who underwent sentinel lymph node (SLN) mapping alone, compared with patients who underwent systematic lymphadenectomy (LND).

Methods Newly diagnosed USC at our institution between 1/1/1996 and 12/31/2017 were reviewed. Patients were assigned to two cohorts: those who underwent SLN mapping alone (SLN Cohort); and those who underwent systematic [pelvic and paraaortic] LND without SLN mapping (LND Cohort). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method.

Results In total, 245 patients were available for analysis. Of these, 79 (32.2%) underwent only SLN mapping and 166 (67.7%) underwent systematic LND. Patients in the SLN cohort had a median age of 66 years, compared to 68 years in the LND cohort (p>0.05). Median follow-up time was 23 months (range, 1–96) in the SLN cohort and 66 months (range, 4–265) in the LND cohort (p<0.001). In patients with stage I/II disease (n=160, 60.1%), the 2-year OS was 96.6% (SE ±3.4) in the SLN cohort and 89.6% (SE ±2.2) in the LND cohort (p=0.8). In patients with stage III disease (n=77), the 2-year OS was 73.6% (SE ±10.2) in the SLN cohort and 77.3% (SE±5.8) in the LND cohort (p=0.8).

Conclusions SLN mapping alone and systematic pelvic and paraaortic nodal dissection (LND) led to similar survival outcomes in patients with stage I-III USC. In our practice, the SLN mapping algorithm has replaced systematic LND as the primary staging modality in the setting of apparent uterine-confined endometrial serous cancer.