Article Text
Abstract
Introduction Sentinel lymph node (SNL) mapping plays a crucial role in staging patients with an apparent early-stage endometrial cancer. The reported detection rate is between 80% to over 95% and depends on multiple factors. Older age may be associated with lower detection rates due to factors such as decreased lymphatic flow; but consensus is lacking. This study aims to evaluate SNL detection rate by age in patients undergoing minimally invasive surgery for endometrial cancer.
Methods We included all consecutive apparent early-stage endometrial cancer patients who underwent surgical staging with SLN biopsy at three referral cancer institutions in Italy from January 2020 to December 2023. Elderly patients were considered those aged 65 years or older. Clinicopathological characteristics according to elderly status were assessed using univariate analysis, and predictors of bilateral SLN mapping were determined through multivariate analysis.
Results Overall, 539 patients were identified: 305 (56.6%) patients were classified as non-elderly and 234 (43.4%) as elderly. The non-elderly group showed higher tumor grade (p<0.001), greater myometrial invasion (p<0.001), and increased adjuvant therapy administration (p<0.001) compared to the elderly group. Rate of bilateral SLN detection was significantly higher in the non-elderly cohort compared to the elderly cohort (94.8% vs 87.2%, p=0.002) (table 1).The multivariable analysis confirmed the elderly status as one of the factors independently associated with lower bilateral SLN detection rate (OR: 0.40, p<0.007) (table 2).
Conclusion/Implications Our findings showed reduced bilateral SLN detection rate in older patients. Nevertheless, the observed detection rate remained substantial, underscoring the feasibility of the technique also in this group.