Endometrial cancer: sentinel node mapping vs lymphadenectomy

  • Bogani G & et al.
  • Gynecol Oncol
  • 2 Apr 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Sentinel node mapping is noninferior to lymphadenectomy with respect to detection of paraaortic nodal involvement and recurrence rates.
  • Sentinel node mapping may offer better detection of positive pelvic nodes.

Why this matters

  • National Comprehensive Cancer Network guidelines approved sentinel node mapping for endometrial cancer staging procedures in endometrial cancer.
  • Although findings support noninferiority of sentinel node mapping, prospective validation is needed.

Study design

  • Meta-analysis of 6 studies including 3536 patients with endometrial cancer.
  • 35.3% of patients underwent sentinel node mapping, and 64.7% had lymphadenectomy.
  • Funding: None.

Key results

  • Positive pelvic nodes were detected in 14.7% of patients undergoing sentinel node mapping vs 9.9% of those having lymphadenectomy (OR, 2.03; P=.002).
    • Low-risk patients: OR, 3.12 (P=.01).
    • Intermediate-/high-risk patients: OR, 2.04 (P=.009).
  • No significant difference was observed in para-aortic node detection rate between patients who received sentinel node mapping vs lymphadenectomy (OR, 0.93; P=.86).
  • Overall recurrence rate was similar with sentinel node mapping and lymphadenectomy (4.3% vs 7.3%; OR, 0.90; P=.63).
  • Nodal recurrence rates were similar between groups (1.2% vs 1.7%; OR, 1.51; P=.29).

Limitations

  • Retrospective studies were included.

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