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572 Seneca sentinel: risk factors for unsuccessful bilateral sentinel lymph node mapping in endometrial cancer
  1. Felix Boria1,
  2. Enrique Chacon2,
  3. Antonio Gonzalez1,
  4. Luisa Sánchez-Lorenzo1,
  5. José Ángel Mínguez2 and
  6. Luis Chiva1
  1. 1Clinica Universidad de Navarra, Madrid, Spain
  2. 2Clinica Universidad de Navarra, Pamplona, Spain


Introduction/Background Sentinel Lymph Node (SLN) mapping has become the established method for assessing lymph nodes in endometrial cancer. Our study aims to assess the risk factors associated with the failure of lymph node mapping in a large European cohort.

Methodology The SENECA study was a retrospective multicenter international observational study that reviewed data from 2139 women with presurgical stage I-II endometrial cancer. Between January 2021 and December 2022, patients underwent surgical treatment with SLN assessment. Risk factors associated with the absence of bilateral mapping were analyzed using chi-squared and T-student tests, as appropriate. All factors that showed statistical associations were included in multivariate regression analysis.

Results Among the 2139 patients, the rate of bilateral lymph node detection was 82.7%, while the rate of unilateral detection was 97.3%. Univariate analysis revealed the following factors associated with bilateral detection: high-grade histology (83.7% for low grade vs. 79.2% for high grade; p=0.027), cervical invasion (83.2% for no invasion vs. 77.3% for invasion; p=0.044), myometrial invasion >50% (84.3% for no invasion vs. 79.7% for invasion; p<0.01), use of ICG tracer (53% for no ICG vs. 83.9% for ICG; p<0.01), volume of tracer >3mL (79.2% for <3mL vs. 84.1% for >3mL; p<0.01), surgical approach (83.5% for minimally invasive surgery vs. 69% for open surgery; p<0.01), and center caseload >90 cases/year (81.2% for low volume vs. 85.5% for high volume; p<0.01). In multivariate analysis, four risk factors remained statistically associated with unsuccessful bilateral lymph node mapping: high grade (OR 1.31, 95% CI 0.996–1.736; p=0.05), myometrial invasion >50% (OR 1.34, 95% CI 1.06–1.7; p=0.017), low-volume center (OR 1.36, 95% CI 1.06–1.74; p=0.016), and non-ICG tracer (OR 4.38, 95% CI 2.6–7.38; p<0.01).

Conclusion Our study identifies four risk factors associated with unsuccessful lymph node mapping and underscore the importance of using ICG as a tracer when performing lymph node mapping.

Disclosures No.

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