TY - JOUR T1 - Surgical and oncological outcomes of sentinel lymph node sampling in elderly patients with intermediate to high-risk endometrial carcinoma JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 875 LP - 881 DO - 10.1136/ijgc-2022-003431 VL - 32 IS - 7 AU - Emad Matanes AU - Neta Eisenberg AU - Cristina Mitric AU - Amber Yasmeen AU - Sara Ismail AU - Oded Raban AU - Tal Cantor AU - David Knigin AU - Susie Lau AU - Shannon Salvador AU - Walter Gotlieb AU - Liron Kogan Y1 - 2022/07/01 UR - http://ijgc.bmj.com/content/32/7/875.abstract N2 - Objective We aimed to evaluate the surgical and oncological outcomes of elderly patients with intermediate to high-risk endometrial cancer undergoing staging with sentinel lymph node (SLN) sampling and pelvic lymphadenectomy.Methods We conducted a retrospective study of elderly (>65-year-old) patients diagnosed with endometrial cancer between December 2007 and August 2017. These patients had been treated at a single center in Montreal, Canada. We compared the surgical and oncological outcomes of three cohorts undergoing surgical staging in non-overlapping eras: 1) lymphadenectomy, 2) lymphadenectomy and SLN sampling, 3) SLN sampling alone. Using life tables, Kaplan-Meier survival curves and log-rank tests, we analyzed 2-year progression-free survival, overall survival, and disease-specific survival.Results Our study included 278 patients with a median age of 73 years (range; 65–91): 84 (30.2%) underwent lymphadenectomy, 120 (43.2%) underwent SLN sampling with lymphadenectomy, and 74 (26.6%) had SLN sampling alone. The SLN sampling alone group had shorter operative times with a median duration of 199 minutes (range, 75–393) compared with 231 (range, 125–403) and 229 (range, 151–440) minutes in the SLN sampling with lymphadenectomy and lymphadenectomy cohorts; respectively (p<0.001). The SLN sampling alone group also had lower estimated blood loss with a median loss of 20 mL (range, 5–150) vs 25 mL (range, 5–800) and 40 mL (range, 5–400) in the SLN sampling with lymphadenectomy and lymphadenectomy cohorts, respectively (p=0.002). The 2 year overall survival and progression-free survival were not significantly different between the three groups (p=0.45, p=0.51, respectively). On multivariable analysis after adjusting for age, American Society of Anesthesiologists (ASA) score, stage, grade, and lymphovascular space invasion, adding SLN sampling was associated with better overall survival, (HR 0.2, CI [0.1 to 0.6], p=0.006) and progression-free survival (HR 0.5, CI [0.1 to 1.0], p=0.05).Conclusion Sentinel lymph node-based surgical staging is feasible and associated with better surgical outcomes and comparable oncological outcomes in elderly patients with intermediate and high-risk endometrial cancer.Data are available upon reasonable request. ER -