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2022-RA-221-ESGO Hysterectomy alone vs. hysterectomy plus sentinel node mapping in endometrial cancer: long-term results from a multi-institutional study
  1. Giorgio Bogani1,
  2. Violante Di Donato2,
  3. Andrea Papadia3,
  4. Alessandro Buda4,
  5. Jvan Casarin5,
  6. Fabio Ghezzi5,
  7. Roberto Angioli6,
  8. Francesco Plotti7,
  9. Daniela Luvero7,
  10. Fabio Landoni8,
  11. Pierluigi Benedetti Panici9,
  12. PierAndrea de Iaco10,
  13. Myriam Perrone10,
  14. Flavia Sorbi11,
  15. Simone Ferrero12,
  16. Michel Mueller13 and
  17. Francesco Raspagliesi14
  1. 1Gynecologic Oncology, La Sapienza of Rome, Rome, Italy
  2. 2University La Sapienza of Rome, Roma, RM, Italy
  3. 3University of Lugano, Lugano, Switzerland
  4. 4Michele e Pietro Ferrero Hospital, Verduno, Italy
  5. 5University of Insubria, Varese, Italy
  6. 6Campus Biomedico, Rome, Italy
  7. 7Campus Biomedico, Roma, RM, Italy
  8. 8Unversity Milano Bicocca, Monza, Italy
  9. 9University La Sapienza of Rome, Rome, Italy
  10. 10University of Bologna, Bologna, Italy
  11. 11University of Firenze, Florence, Italy
  12. 12University of Genova, Genova, Italy
  13. 13University of Bern, Bern, Switzerland
  14. 14Fondazione IRCCS Istituto Nazionalw dei Tumori di Milano, Milano, Italy


Introduction/Background To compare outcomes after hysterectomy and hysterectomy plus sentinel node mapping (SNM) in endometrial cancer (EC) patients.

Methodology This is a retrospective study, collecting data from EC patients treated between 2006 and 2016 in nine referral centers.

Results The study population included 398 (69.5%) and 174 (30.5%) patients having hysterectomy and hysterectomy plus SNM. As the results of the adoption of a propensity-score matched analysis, we selected two homogeneous cohorts of patients (150 having hysterectomy only vs. 150 having hysterectomy plus SNM). The execution of sentinel node mapping correlated with longer operative time, but it is not influencing the length of hospital stay and estimated blood loss. Overall severe complication rates were similar between groups (0.7% in the hysterectomy group vs. 1.3% in the hysterectomy plus SNM group; p=1.00). No lymphatic-specific complication occurred. Overall, 12.6% of patients having SNM were diagnosed with disease harboring in their lymph nodes. Adjuvant therapy administration rate was similar between groups. Considering patients having SNM, 4% of patients received adjuvant therapy on the basis of nodal status only; all the other patients received adjuvant therapy on the basis of uterine risk factors. Five-year disease-free (p=0.720) and overall (p=0.632) survival was not influenced by the surgical approach.

Conclusion Hysterectomy (with or without SNM) is a safe and effective method for managing EC patients. Potentially, these data support the omission of side-specific lymphadenectomy in case of unsuccessful mapping. Further evidence is warranted to confirm the role of SNM in the era of molecular/genomic profiling.

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