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Abstract
Introduction/Background The Sentinel Node technique allows knowing the lymph node status in the endometrial cancer (EC) and higher detection rates. However, in cases of non-detection, a lymphadenectomy is required to determine its lymph node status.
The intraoperative study by freezing has a low sensitivity (60%). However, the OSNA technique can be performed intraoperatively, constitutes a definitive diagnosis of lymph node status and has already been validated in Gynecology.
Our objective is to present an algorithm that makes it possible to minimize the need for lymphadenectomy in patients with nodal areas not detected on EC.
Methodology 116 patients with SLNB in EC have been retrospectively analyzed (from January 1, 2021 to January 31, 2023).
Patients are stratified according to preoperative risk, including the molecular profile of the tumor.
All patients undergoing surgery for EC require a prior biopsy that specifies the type and histological grade of the tumor, and molecular profile, including CK19.
Intraoperative study is performed only in those patients with CK19(+), 56% of the sample.
If the aortic or pelvic OSNA study were negative and there was no detection in an area, lymphadenectomy would be required in that area. Otherwise, if it were positive, its execution would be omitted.
Results In 9 high or intermediate risk patients there was no bilateral pelvic detection, and they underwent the OSNA IO technique.
8 low-risk patients without bilateral pelvic detection had aortic detection in 6 of them. OSNA technique could also be performed on them selectively.
12.9% of the series could benefit from knowing the lymph node status, of which the OSNA IO technique could be performed in 56%.
Conclusion Carrying out an intraoperative study of the sentinel node is interesting to minimize the number of lymphadenectomies to be performed in the EC.
Classic preoperative risk groups in endometrial cancer. If known molecular profile POLE(+) confined to the uterus, corresponds to low risk. p53abn would be intermediate risk if it does not infiltrate myometrial, and high risk if it infiltrates myometrium.
Disclosures OSNA technique can be performed intraoperatively in endometrial cancer.