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  • #221 The SENTIREC-endo study – risks and benefits of a national adoption of sentinel node mapping in low and intermediate risk endometrial cancer

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Poster/ePoster Sessions
03. Endometrial cancer
#221 The SENTIREC-endo study – risks and benefits of a national adoption of sentinel node mapping in low and intermediate risk endometrial cancer
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  1. Sarah Marie Bjørnholt1,
  2. Sara Elizabeth Sponholtz2,
  3. Ole Mogensen3,
  4. Kirsten Bouchelouche4,
  5. Erik Thorlund Parner5,
  6. Gudrun Neumann6,
  7. Kirsten Marie Jochumsen6,
  8. Bushra Hassan Hamid7,
  9. Morten Bülow Davidsen7,
  10. Signe Frahm Bjørn8,
  11. Katja Dahl1 and
  12. Pernille Tine Jensen1
  1. 1Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
  3. 3Department of Gynecology and Obstetrics, Aarhus University Hospital,, Aarhus, Denmark
  4. 4Department of Clinical Medicine – Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
  5. 5Department of Public Health and biostatistics, Aarhus University, Aarhus, Denmark
  6. 6Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
  7. 7Department of Gynecology and Obstetrics, Herlev Hospital, Herlev, Denmark
  8. 8Department of Gynecology and Obstetrics, Rigshospitaletal, Copenhagen, Denmark

Abstract

Introduction/Background Surgical staging of endometrial cancer (EC) serves to allocate women with lymph node metastases to adjuvant treatment. Sentinel lymph node (SLN) mapping has shown high accuracy to detect lymph node metastases in women with EC of low- or intermediate-risk (LR or IR) of lymph node metastases. The SENTIREC-endo study aims to investigate risks and benefits of a national protocolled adoption of SLN mapping to women with LR and IR EC, in a real-life clinical setting.

Methodology Preceded by a surgeon proficiency study, we performed a national multicenter prospective study of SLN-mapping in women with LR and IR EC from March 2017-February 2022. Postoperative complications were classified according to Clavien-Dindo. Lymphoedema was evaluated by validated patient-reported outcome measures at baseline and three months postoperatively. The Lymphoedema score was linearly transformed from 0 to 100 according to guidelines. Lymphoedema was assessed as a mean difference score and as incidence of swelling and heaviness, scores was compared using paired t-test.

Results 627 women were included in the analyses, 458 with LR- and 169 with IR EC. The SLN detection rate was 94.3% (591/627). The overall incidence of lymph node metastases was 9.3% (58/627), 4.4% (20/458) in the LR- and 22.5% (38/169) in the IR group. Only 0.3% (2/627) experienced an intraoperative complication associated with the SLN procedure. The incidence of postoperative complications was 8% (50/627). The mean difference score of lymphoedema was below the threshold for clinical importance 4.3/100 (95%CI 2.6–5.9). The incidence of leg swelling and heaviness was low, 5.2% and 6.1%, respectively.

Conclusion SLN mapping is a safe staging procedure in women with EC of LR and IR, carrying a very low risk of early lymphoedema, perioperative- and postoperative complications. The national change of clinical practice contributed to a more correct treatment allocation for both risk groups and thus supports further international implementation.

Disclosures There are no conflicts of interest to disclose.

https://doi.org/10.1136/ijgc-2023-ESGO.288

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