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Incorporation of a Sentinel Lymph Node Mapping Algorithm in Patients with Clinical Stage I Endometrial Cancer
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  • Sarah Wener,
  • Therese Gadomski,
  • Tung Ming Leung,
  • Elena Pereira,
  • Jeaninne Villella
Sarah Wener
Lenox Hill Hospital

Corresponding Author:[email protected]

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Therese Gadomski
Lenox Hill Hospital
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Tung Ming Leung
Northwell Health Feinstein Institutes for Medical Research
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Elena Pereira
Lenox Hill Hospital
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Jeaninne Villella
Lenox Hill Hospital
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Abstract

Objective: Sentinel lymph node biopsy (SLNB) has emerged as an alternative to complete lymph node dissection (PPALND) in the management of endometrial cancers. The referenced data is published from high-volume specialized institutions and PPALND is still performed by many at smaller, non-specialized centers. Our aim is to demonstrate that SLNB is feasible, reproducible, and sensitive without affecting cancer-specific outcomes when implemented at a non-specialized center. Setting: Patients with clinical stage I endometrial cancer were reviewed from 2016 through 2020. Population: A total of 92 patients were included: 69 stage IA, 12 stage IB, 3 stage II and 8 stage III. Endometrioid (73%), followed by UPSC (15.0%), MMMT (5.0%) and CC (4%). Methods: Endometrioid, uterine papillary serous (UPSC), malignant mixed mesodermal tumor (MMMT), and clear cell (CC) histologies were included. Complete PPALND was performed for patients with MMMT, UPSC or CC. Sentinel lymph nodes (SLN) were evaluated using ultra-staging protocols. The medical record was queried for evidence of recurrence. Results: A total of 92 patients were included: 69 stage IA, 12 stage IB, 3 stage II and 8 stage III (2 IIIA, 2 IIIC1, 4 IIIC2). At least one SLN was detected in 95.4% of cases. The bilateral SLN detection was 74.3% and improved from 2017-2019: 70%-80%. Non-SLN were positive in 3 patients, all with high-risk histology. There have been no recurrences to date. Conclusions: Our results are comparable to the rates reported in literature and demonstrate that when applied at non-specialized centers this approach is safe and reproducible. Funding: None