Article Text

Download PDFPDF

10 The adoption of sentinel node mapping with or without backup lymphadenectomy in endometrial cancer
  1. G Bogani1,
  2. R Angioli2,
  3. F Plotti2,
  4. VDI Donato3,
  5. A Papadia4,
  6. L Muzii3,
  7. P Benedetti Panici3,
  8. S Ferrero5,
  9. A Buda6,
  10. F Landoni6,
  11. J Casarin7,
  12. F Ghezzi7,
  13. P De Iaco8,
  14. AM Perrone8 and
  15. F Raspagliesi1
  1. 1Fondazione IRCCS Istituto Nazionale dei Tumori , Gynecologci Oncology, Milano, Italy
  2. 2Campus Biomedico di Roma, Gynecologci Oncology, Roma, Italy
  3. 3University La Sapienza di Roma, Roma, Italy
  4. 4University of Lugano, Switzerland
  5. 5University of Genoa, Genova, Italy
  6. 6Building U6 – University of Milano-Bicocca, Milano, Italy
  7. 7University of Insubria, Varese, Italy
  8. 8Alma Mater Studiorum – Università di Bologna, Bologna, Italy


Introduction/Background*Sentinel node mapping (SNM) has replaced lymphadenectomy for staging surgery in apparent early-stage endometrial cancer (EC). Here, we evaluate the long-term survival of three different approaches of nodal assessment in low, intermediate, and high-risk EC.

Methodology This is a multi-institutional retrospective study evaluating long-term outcomes (at least 3 years of follow-up) of EC patients having nodal assessment between 2006 and 2016. In order to reduce possible confounding factors, we applied a propensity-matched algorithm.

Result(s)*Charts of 940 patients were evaluated: 174 (18.5%), 187 (19.9%), and 579 (61.6%) having SNM, SNM followed by backup lymphadenectomy and lymphadenectomy, respectively. Applying a propensity score matching algorithm (1:1:2) we selected 500 patients: 125 SNM vs. 125 SNM plus backup lymphadenectomy vs. 250 lymphadenectomy. Baseline characteristics of the study population were similar between groups. The prevalence of nodal disease was 14%, 16%, and 12% in patients having SNM, SNM followed by backup lymphadenectomy and lymphadenectomy, respectively. Overall, 19 (7.6%) patients were diagnosed with low volume nodal disease (7 and 12 patients with micrometastasis and isolated tumor cells). The mean (SD) follow-up time was 62 (±11) months. The survival analysis comparing the three techniques did not show statistical differences in terms of disease-free (p=0.750) and overall survival (p=0.899). Similarly, the type of nodal assessment did not impact survival outcomes after stratification on the basis of uterine risk factors.

Conclusion*Our study highlighted that SNM provides similar long-term oncologic outcomes than lymphadenectomy. Further evidence is warranted to assess the prognostic value of low-volume disease detected by ultrastaging and the role of molecular/genomic profiling.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.