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2022-RA-639-ESGO Implementation of the new surgical management in endometrial cancer in accordance to ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma by trainees in gynaecological oncology
  1. Maja Mrugala,
  2. Krzysztof Nowak,
  3. Mariusz Kasperski,
  4. Marcin Kalus and
  5. Ewa Milnerowicz-Nabzdyk
  1. Oncological Gynaecology Department, Centre of Oncology in Opole, Opole, Poland


Introduction/Background The ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma published in December 2020 recommend a sentinel node biopsy instead of systematic lymphadenectomy in patients with low-risk/intermediate-risk disease and may be considered in stage I/II with high-intermediate-risk/high-risk. This revolutionary minimally invasive approach let the patients avoid the intra- and postoperative complications but also brings the opportunity for trainees to obtain an excellence in procedure in the relatively brief time.

Methodology In a time of 8 months (October 2021-May 2022) 31 patients with diagnosed endometrial cancer stages IA and IB with low or intermediate risk underwent the procedure of total hysterectomy with bilateral salpingo-oophorectomy and sentinel node biopsy in Oncology Centre in Opole done by 4 surgeons: 2 specialists and 2 trainees. All of the surgeries were performed in accordance to the state-of-art principles which consisted of ICG mapping, ultrastaging of the lymph nodes and gynaecological oncology specialist supervision.

Results 78% of the procedures were performed by 2 trainees as a first surgeon and 22% by 2 specialists. All of the operations were minimally invasive (laparoscopy). In 28 cases (90,4%) at least one lymph node was detected and the median number of SLN was 3. In 3 cases (9,6%) the lymph nodes were not identified in the dissected tissue – two of them conducted by specialists and one by a trainee. Unsuccessful mapping of nodes appeared only twice in the group (6,45%) and in these cases a systematic pelvic lymphadenectomy was accomplished. Metastatic nodes were found in 4 cases (12,9%).

Conclusion The results of the observations indicate that the novel surgical approach in endometrial cancer may be effectively implemented just in months and conducted by supervised trainees as we obtained satisfactory outcome compared to bigger studies.

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