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EP602 The role of sentinel node assessment and laparoscopic approach in decreasing morbidity of staging surgery for endometrial cancer
  1. R Poka,
  2. I Baradács,
  3. S Molnár and
  4. Z Krasznai
  1. Obstetrics and Gynaecology, University of Debrecen, Debrecen, Hungary


Introduction/Background Lymphadenectomy and associated medical disorders of the typical endometrial patient urge gynaecological oncologists to promote the use of laparoscopic approach and sentinel node diagnostics to reduce morbidity.

Methodology Retrospective chart review was performed to assess the complications of staging surgery of different strategies among endometrial cancer patients. Body mass index (BMI), preoperative (preop) and postoperative (postop) haemoglobin levels (Hb), the duration of hospitalisation, Clavien-Dindo-classified intraoperative and postoperative morbidities were compared between laparoscopic (LSC) and open laparotomy (LAP) procedures, as well as between cases with sentinel-node (SLND) identification and systematic lymphadenectomy (PLND). The Patent-Blau technique was used for sentinel node identification. Significance of differences between continuous and categorical variables was assessed with t-test and χ2-test or Wilcoxon-test, respectively.

Results Consecutive cases of 45 PLND and 28 SLND were identified. Preop Hb (135 vs 138 g/100 mL) and BMI (34.1 vs 32.8 kg/m2) showed no difference between PLND and SLND cases. Postop Hb was lower in PLND cases compared to that of SLND cases (120 vs 128 g/100 mL, p<0.05). PLND cases required longer hospitalisation (median 9 days vs 5 days, p<0.05). More complications and higher-grade complications occurred in the PLND group then in the SLND group (p<0.05). Subgroup analysis within the LSC group (19 cases with SLND and 27 cases with PLND) revealed similar median duration of hospitalisation (4 days), but there were more complications among PLND cases. Preop and postop Hb did not differ between LSC and LAP cases (134 vs 137 g/100 mL, and 120 vs 122 g/100 mL, respectively). Hospitalisation was longer among LAP cases compared to LSC cases (median 9 days vs 4 days, p<0.05). Complication rate was higher in LAP cases than in LSC cases (12 vs 4 cases).

Conclusion Both the LSC approach and the SLND technique reduces the morbidity of surgical staging of endometrial cancer.

Disclosure Nothing to disclose.

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