Introduction/Background Lymphatic assessment in high-grade endometrial cancers (HGEC) has traditionally involved comprehensive lymph node dissection (LND). However, the use of sentinel lymph node (SLN) has emerged as a potential alternative to this approach. We aim to compared overall survival (OS), disease-free survival (DFS), positive lymph node rate (PLNR) and complications between both techniques.

Methodology A retrospective study, including 70 patients diagnosed with HGEC and ostensibly staged at I-II (FIGO2009) based on imaging studies, including MRI, CT, PET-CT, and/or ultrasound. Group-1 (50/70, 71.4%) underwent pelvic LND with or without para-aortic LND between January/2015-June/2018. Group-2 (20/70, 28.6%) underwent pelvic SLN technique between July/2018-December/2020. Both groups had a mean follow-up of 48 months.

Results There were no significant differences in age (66.8 vs 67.96) [p0.673] or BMI (34.3 vs 31.7) [p0.427] for SLN vs LND groups, respectively. SLN group was approached robotically in 100% (20/20) of the cases. 90% (45/50) of LND cases had a minimally invasive approach (78% robotic) and 10% (5/50) were open surgery.

Number of nodes for the SLN group was 4.95(1–20) and 14.7(1–78) for LND. PLNR was 10% (2/20) for SLN and 16% (8/50) for LND. There was a SLN detection rate of 90% (18/20), 70% (14/20) bilateral detection. LND group had 8% (4/50) of complications compared to 5% (1/20) in SLN group [p 0,660].

There were 5% (1/20) recurrences in the SLN group and 34% (17/50) for LND group [p0.06]. The OS 48 vs 42.13 months [p0.06] and DFS 18 vs 26.4 months [p 0.710] for SLN vs LND group respectively. Adjuvant treatment was administered to 80% (16/20) of the SLN group and 96% (47/50) of the LND group [p=0.06].

Conclusion Our study suggests that performing SLN mapping have similar PLNR and complications without affecting the OS or DFS compared to comprehensive LND technique.

Disclosures The authors have nothing to disclose.