For the treatment of obvious early-stage endometrial cancer (EC), sentinel lymph node mapping (SNM) has become increasingly popular. Here, researchers examined how well 3 distinct methods of nodal assessment held up over time. Long-term results of patients with EC who underwent nodal assessment between January 1, 2006, and December 31, 2016, were studied in this retrospective study conducted at many institutions. Investigators used a propensity-matched technique to help eliminate some potential sources of bias. Of the 940 patients who met the criteria for inclusion, 174 (18.5%), 187 (19.9%), and 579 (61.6%) underwent SNM, followed by backup lymphadenectomy (LND) or LND alone, respectively. About 500 patients were chosen using a 1:1:2 propensity score matching technique, with 125 receiving SNM, 125 receiving SNM with a backup LND, and 250 receiving LND. The study population’s baseline characteristics were consistent across both groups. Patients with SNM, SNM with backup LND, and LND all had higher rates of nodal disease than those with SNM alone (14%) or without any nodal treatment (12%). Low volume nodal illness was identified in 19 patients (7.6%). There were no statistically significant differences between the 3 methods in terms of disease-free (P=0.750) or overall survival (P=0.899) in the survival analysis. Similarly, when adjusting for uterine risk factors, the method of nodal evaluation did not affect survival rates. The findings show that SNM is comparable to LND regarding long-term oncologic outcomes.

Source: sciencedirect.com/science/article/pii/S0090825822004073