Sentinel Lymph Node Biopsy versus Complete Lymphadenectomy in The Management of Endometrial Carcinoma

Abstract

Background: 320,000 new instances of endometrial cancer (EC) are thought to occur annually worldwide, making it the fifth most  frequent malignancy in women.

Objective: To assess the diagnostic accuracy and clinical impact of sentinel lymph node (LN) mapping in  the management of EC. Patients and Method: This prospective study was conducted on 23 patients who attended the Gynecology and  Obstetrics clinic in Menoufia University Hospital and were diagnosed to have endometrial carcinoma by histopathological examination,  from September 2019 until July 2022.

Results: Sentinel lymph node biopsy (SLNB) is an efficient diagnostic tool in the management of  endometrial carcinoma with 9 (81.82%) TP, 9 (90%) TN, 1 (10%) FP, 2 (18.18%) FN, 85.7% diagnostic accuracy, 81.8% sensitivity, 90%  specificity, 90% PPV and 81.8% NPP. SLN mapping (Number of SLNs, SLNs metastases, type of metastases) were insignificantly different  between frozen section and permanent section. Hysterectomy type was simple in 21 (91.3%) patients and was radical in 2 (8.7%) patients.  Regarding histologic subtype of the studied patients, 2 (8.7%) patients had serous subtype, 9 (39.13%) patients had grade III  endometrioid subtype, 10 (43.5%) patients had grade II endometrioid subtype, 1 (4.35%) patient had carcinosarcoma subtype, 1 (4.35%)  patient had clear cell subtype.

Conclusion: SLNB is an effective diagnostic technique for the treatment of endometrial carcinoma.    Retroperitoneal lymphadenectomy increases intraoperative and postoperative complications.