Relevance of sentinel lymph node biopsy in early endometrial cancer: A series of 249 cases

Objective We aimed to evaluate the impact of the sentinel lymph node (SLN) biopsy on adjuvant therapy, recurrence and survival in early endometrial cancer (EC). Study design We retrospectively included all patients who underwent SLN biopsy for EC between February 2007 and March 2018. Results Of the 249 EC patients included, the overall SLN detection rate was 91 %. SLNs were positive in 36 (14.4 %) cases. Nine of the 13 preoperative low-risk patients with positive SLNs were re-operated and 22 % presented positive non-SLNs. No second surgery was required for the 10 patients upstaged to intermediate risk after negative SLN biopsy. Nine of the 11 preoperative intermediate-risk patients with positive SLNs were re-operated and 33 % presented positive non-SLNs. Eleven of the 24 preoperative high-risk patients with negative SLNs were re-operated and 27 % presented positive non-SLNs. For the whole population, 3-year overall survival was 99 % (CI 95 % (97−1)) and 3-year recurrence-free survival (RFS) was 92 % (CI 95 % (0.87−0.95)). Conclusion Our study supports the feasibility of the SLN procedure for assessing risk recurrence in patients with early-stage EC. SLN biopsy should lead to major reductions in secondary staging and better adaptation of adjuvant therapy.