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  • 774 Ten years of sentinel lymph node mapping in endometrial cancer: real world data on the impact of lymphovascular space invasion on the diagnostic performance of sentinel lymph node mapping

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03. Endometrial cancer
774 Ten years of sentinel lymph node mapping in endometrial cancer: real world data on the impact of lymphovascular space invasion on the diagnostic performance of sentinel lymph node mapping
  1. Carol A Büchi1,
  2. Franziska Siegenthaler1,
  3. Laura Sahli1,
  4. Andrea Papadia2,3,
  5. Flurina Saner1,
  6. Stefan Mohr4,
  7. Tilman T Rau5,
  8. Wiebke Solass6,
  9. Sara Imboden1 and
  10. Michael D Mueller1
  1. 1Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, Bern, Switzerland
  2. 2Department of Gynecology and Obstetrics, Ente Ospedaliero Cantonale of Lugano, Lugano, Switzerland
  3. 3Facoltà di Scienze Biomediche, Università della Svizzera Italiana, Lugano, Switzerland
  4. 4Department of Gynecology and Obstetrics, Bürgerspital Solothurn, Solothurn, Switzerland
  5. 5Institute of Pathology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
  6. 6Institute of Tissue Medicine and Pathology, University of Bern, Bern, Switzerland

Abstract

Introduction/Background Sentinel lymph node (SLN) mapping has emerged as a standard of care in endometrial cancer, due to its high sensitivity and significant reduction in operative morbidity. Although lymphovascular space invasion (LVSI) is a known risk factor for lymph node-metastasis and recurrence, evidence on the reliability of SLN mapping in LVSI-positive patients is scarce. The aim of this study was to determine the impact of LVSI on the diagnostic performance of SLN mapping.

Methodology This retrospective cohort study included patients with endometrial cancer who underwent primary surgical treatment including SLN mapping at the Bern University Hospital, Switzerland, between 2012 and 2022.

Results Out of the 674 patients who underwent primary surgical treatment for endometrial cancer, 466 had minimally invasive SLN mapping with indocyanine green. LVSI was present in 22% of the study patients and was significantly associated with lymph-node metastasis (P < .001) and recurrence (P < .001). In node negative patients with only SLN mapping performed, LVSI was an independent predictor of recurrence in multivariable Cox regression analysis (P = .036). Negative predictive value of SLN mapping was 90.6% overall and significantly lower in tumors with evidence of LVSI (74%) compared to LVSI negative tumors (95%, P = .004).

Conclusion In our study of patients with endometrial cancer, the presence of LVSI was significantly associated with worse oncological outcomes. LVSI was an independent predictor of recurrence in node-negative patients with only SLN mapping performed. Furthermore, negative predictive value of SLN mapping was significantly lower in tumors with evidence of LVSI.

Disclosures No disclosures.

https://doi.org/10.1136/ijgc-2024-ESGO.382

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