Introduction Endometrial cancer is a common gynecological malignancy. Lymph node information is important for evaluating the prognosis. Current studies have shown that sentinel lymph node mapping (SLNM) in early stage low-risk endometrial cancer has satisfactory SLN detection rate, sensitivity without affecting PFS and OS. However, the feasibility of SLNM in early stage high-risk endometrial cancer is still under hot debate.

Methods The PubMed, Embase, Cochrane Library, Web of science, and Scopus were retrieved.The search deadline is November 1, 2022. Inclusion criteria was, over 10 patients, only high-risk endometrial cancer, detection rate, sensitivity and PFS, OS, recurrence rate were reported.

Results A total of 17 articles met the inclusion criteria, of which 12 were diagnostic studies, 7 were therapeutic studies. The total SLN detection rate is 85% .The bilateral detection rate of SLN is 62.5%. The detection rate of para-aortic SLN is 11.1%. The detection rate of isolated para-aortic SLN detection rate is 0.3%. The sensitivity is 91%. The SLNM group has a lower recurrence rate than that in the LAD group (OR: 0.504;p = 0.0001); SLNM group reduces the risk of death compared to LAD group, 36-month OS is better (HR = 0.30; p = 0.02),

Conclusion/Implications The application of SLNM in early stage high-risk EC patients is feasible with good SLN detection rate and sensitivity.Compared with traditional LAD, SLNM has similar positive lymph node detection rate and adjuvant therapy rate, not affecting PFS and OS. It may even reduce the risk of recurrence by identifying the lymph nodes which are most relevant to metastasis.