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EPV142/#638 Demonstration of a learning curve in the initiation of sentinel lymph node mapping in endometrial cancer in a welsh tertiary gynae cancer centre
  1. L Rider,
  2. K Lim,
  3. R Howells,
  4. A Sharma,
  5. J Oliviera Davies and
  6. S Jones
  1. University Hospital of Wales, Gynae Oncology, Cardiff, UK


Objectives To audit the outcomes of sentinel lymph node mapping in a Welsh cancer centre, in order to demonstrate a sufficient learning curve to adopt sentinel lymph node biopsy as the mainstay of surgical lymph node mapping in endometrial cancer.

Methods There are no current standards against which to audit the departments learning curve for adoption of sentinel lymph node mapping as endometrial cancer staging. We identified published quality indicators for sentinel lymph node mapping – including <5% false negative rate, >20 cases per surgeon performing the procedure, successful bilateral mapping in >50% of cases. Our local gynae oncology database was searched to identify all cases of sentinel lymph node dissection for endometrial and cervical cancer. Data from the gynae oncology database and the patients electronic clinical record was then collated and analysed using excel.

Results 43 patients were identified having undergone a sentinel lymph node biopsy ± lymphadenectomy for endometrial or cervical cancer. Bilateral sentinel lymph nodes were mapped in 67.4% of cases. In the first 21/43 patients 57.1% were mapped, comparative to 77.3% in latter 22/43 patients. 38 sides with successful lymph node mapping and lymphadenectomy were identified. Sentinel lymph nodes had a 33% sensitivity for identifying lymph node metastasis in the first half of the data set comparative to 100% in the latter half.

Conclusions The data demonstrated a significant learning curve, within the department, in the successful mapping of sentinel lymph nodes in endometrial cancer.

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