RT Journal Article
SR Electronic
T1 Implementation of a sentinel lymph node mapping algorithm for endometrial cancer: surgical outcomes and hospital charges
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP ijgc-2019-000941
DO 10.1136/ijgc-2019-000941
A1 Katherine I Stewart
A1 Jarrod S Eska
A1 Ross F Harrison
A1 Rudy Suidan
A1 Ann Abraham
A1 Gary B Chisholm
A1 Larissa A Meyer
A1 Shannon N Westin
A1 Nicole D Fleming
A1 Michael Frumovitz
A1 Thomas A Aloia
A1 Pamela T Soliman
YR 2020
UL http://ijgc.bmj.com/content/early/2020/01/06/ijgc-2019-000941.abstract
AB Introduction The purpose of this study was to compare operative times, surgical outcomes, resource utilization, and hospital charges before and after the implementation of a sentinel lymph node (SLN) mapping algorithm in endometrial cancer.Methods All patients with clinical stage I endometrial cancer were identified pre- (2012) and post- (2017) implementation of the SLN algorithm. Clinical data were summarized and compared between groups. Total hospital charges incurred on the day of surgery were extracted from the hospital financial system for each patient and all charges were adjusted to 2017 US dollars.Results A total of 203 patients were included: 71 patients in 2012 and 130 patients in 2017. There was no difference in median age, body mass index, or stage. In 2012, 35/71 patients (49.3%) underwent a lymphadenectomy. In 2017, SLN mapping was attempted in 120/130 patients (92.3%) and at least one SLN was identified in 110/120 (91.7%). Median estimated blood loss was similar between groups (100 mL vs 75 mL, p=0.081). There was a significant decrease in both median operative time (210 vs 171 min, p=0.007) and utilization of intraoperative frozen section (63.4% vs 14.6%, p<0.0001). No significant differences were noted in intraoperative (p=1.00) or 30 day postoperative complication rates (p=0.30). The median total hospital charges decreased by 2.73% in 2017 as compared with 2012 (p=0.96).Discussion Implementation of an SLN mapping algorithm for high- and low-risk endometrial cancer resulted in a decrease in both operative time and intraoperative frozen section utilization with no change in surgical morbidity. While hospital charges did not significantly change, further studies are warranted to assess the true cost of SLN mapping.