The purpose of this study was to look at the use, morbidity, and cost of sentinel lymph node mapping in women undergoing hysterectomy for complicated atypical endometrial hyperplasia.
The Perspective database was searched for women with complicated atypical endometrial hyperplasia who had hysterectomy between 2012 and 2018. Perioperative morbidity, mortality, and cost were assessed based on whether sentinel lymph node mapping, lymph node dissection, or no nodal assessment was performed.
Sentinel lymph node mapping was conducted in 620 of the 10,266 women, lymph node dissection in 538, and no lymphatic examination in 9,108. The use of sentinel lymph node mapping climbed from 0.8% in 2012 to 14.0% in 2018, while lymph node dissection increased from 5.7% to 6.4%. Residence in the western United States, treatment at high-volume facilities, and use of robotic-assisted hysterectomy were all linked with sentinel lymph node mapping (P<.05 for all) in an adjusted model.
The complication rates were comparable among the three groups. The median cost for sentinel lymph node mapping ($9,673) and dissection ($9,754) was greater than for people who did not have nodal evaluation ($8,435) (P<.001).