Article Text
Abstract
Introduction To describe the rate and surgical outcomes of sentinel lymph (SLN) node biopsy in patients with endometrial intraepithelial neoplasia (EIN).
Methods An National Surgical Quality Improvement Program database. Women with EIN on postoperative pathology who underwent minimally invasive hysterectomy from 2012 to 2020 were included. Patients’ characteristics and perioperative morbidity were compared between patients who underwent SLN biopsy and those who did not.
Results Overall, 4,447 patients were included, of those 586 (13.2%) underwent SLN biopsy. The proportion of SLN biopsy has increased steadily from 0.6% in 2012, to 26.1% in 2020 (p<.001). In a multivariable regression including age, BMI, and year of surgery, a more recent year of surgery was independently associated with an increased adjusted odds ratio of undergoing SLN biopsy [aOR (95% CI) 1.51 (1.43-1.59)]. Mean total operative time was longer in the SLN biopsy group (139.50 ± 50.34 min. vs. 131.64 ± 55.95 min, p=.001). The rate of any complication was 5.9% vs. 6.7%, major complications was 2.3% vs. 2.4% and minor complications was 4.1% vs. 4.9% for no SLN and SLN, respectively. The rate of venous thromboembolism was higher in the SLN biopsy group [4 (0.7%) vs. 4 (0.1%), p=.013]. In a multivariable regression analysis - performance of SLN biopsy was not associated with any, major or minor complications.
Conclusion/Implications The performance of SLN biopsy in EIN is increasing. Sentinel lymph node biopsy for EIN is associated with an increased risk of venous thromboembolism and a negligible increased surgical time.