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16 Sentinel node mapping in high-intermediate and high-risk endometrial cancer: analysis of 5-year oncologic outcomes
  1. Giorgio Bogani1,
  2. Violante Di Donato2,
  3. Mario Malzoni3,
  4. Enrico Vizza4,
  5. Andrea Papadia5,
  6. Jvan Casarin6,
  7. Antonino Ditto7,
  8. Francesco Multinu8,
  9. Francesco Fanfani9,
  10. Fabio Ghezzi6,
  11. Roberto Berretta10,
  12. Roberto Tozzi11,
  13. Giuseppe Vizzielli12,
  14. Giovanni Scambia13,
  15. Andrea Giannini2 and
  16. Francesco Raspagliesi7
  1. 1IRCCS National Cancer Institute, Milano, Italy
  2. 2Department of Gynecological, Obstetrical and Urological Sciences, ‘Sapienza’ University of Rome, Italy, Rome, Italy
  3. 3Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, Avellino, Italy, Avellino, Italy
  4. 4Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCSS-Regina Elena National Cancer Institute, Rome, Italy, Milan, Italy
  5. 5University of Lugano, Lugano, Swaziland
  6. 6Department of Obstetrics and Gynecology, Women’s and Children’s Del Ponte Hospital, University of Insubria, Varese, Italy
  7. 7Fondazione IRCCS Istituto Nazionale dei Tumori, Gynecological Oncology Unit, Milan, Italy
  8. 8Department of Gynecologic Surgery, IRCCS European Institute of Oncology, Milan, Italy
  9. 9Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
  10. 10Department of medicine and surgery, University Hospital of Parma,, Parma, Italy
  11. 11Department of medicine and surgery, University of Padova, Padova, Italy
  12. 12Clinic of Obstetrics and Gynecology, ‘Santa Maria della Misericordia’ University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
  13. 13Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy


Introduction/Background To assess 5-year oncologic outcomes of apparent early-stage high-intermediate and high-risk endometrial cancer undergoing sentinel node mapping and systematic lymphadenectomy.

Methodology This is a multi-institutional retrospective, propensity-matched study evaluating data of high-intermediate and high-risk endometrial cancer (according to ESGO/ESTRO/ESP guidelines) undergoing sentinel node mapping and systematic pelvic lymphadenectomy with and without para-aortic lymphadenectomy. Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazard methods.

Results The charts of 242 patients with high-intermediate and high-risk endometrial cancer were retrieved. Overall, 73 (30.1%) patients undergoing hysterectomy plus sentinel node mapping met the inclusion criteria. Forty-two (57.5%) and 31 (42.5%) patients were classified in the high-intermediate and high-risk groups, respectively. Unilateral sentinel node mapping was achieved in all patients. Bilateral mapping was achieved in 67 (91.7%) patients. Three (4.1%) patients had site-specific lymphadenectomy (two pelvic areas only and one pelvic plus para-aortic area). In comparison, adjunctive nodal dissection was omitted in the hemipelvis of the other three (4.1%) patients. Sentinel nodes were detected in the para-aortic area in eight (10.9%) patients. Twenty-four (32.8%) patients were diagnosed with nodal disease. A propensity-score matching was used to compare patients undergoing sentinel node mapping with patients undergoing lymphadenectomy. Seventy patient pairs were selected (70 with sentinel node mapping vs. 70 with lymphadenectomy). Patients undergoing sentinel node mapping experienced similar 5-year disease-free survival (HR: 1.233; 95%CI: 0.6217 to 2.444; p=0.547, log-rank test) and 5-year overall survival (HR: 1.505; 95%CI: 0.6752 to 3.355; p=0.256, log-rank test) than patients undergoing lymphadenectomy (figure 1).

Conclusion Sentinel node mapping does not negatively impact 5-year outcomes of high-intermediate and high-risk endometrial cancer. Further prospective studies are warranted

Disclosures The Authors declare no conflicts of interest. No funding sources supported this investigation.

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