Effect of lymph node sampling type on oncologic outcomes in endometrial cancers: comprehensive pelvic and paraaortic lymphadenectomy vs. sentinel lymph node mapping with indocyanine green.

Abstract

Sentinel lymph node biopsy refers to an innovative and minimalist surgical approach that has been introduced to reduce both complications and morbidity. A definitive answer to the question of whether lymphadenectomy is performed for staging or curative purposes in endometrial cancer has not yet been found. The aim of this study is to compare patients who underwent sentinel lymph node biopsy with indocyanine green and those who underwent laparoscopic complete surgical staging in terms of survival. A total of 182 patients was included in the study. The patients were divided into two groups according to the lymph node sample type. The two groups were compared in terms of oncological outcomes. 92 patients underwent sentinel lymph node mapping (SLNM cohort) and 90 patients underwent extensive pelvic and paraaortic lymphadenectomy (SCL cohort). Considering only patients with negative lymph nodes, the Sentinel cohort was associated with a reduced DFS and OS (p=0.008 and p=0.005, respectively). This difference may be due to the longer follow-up times of patients with comprehensive lymph node sampling. On the other hand, There was no difference in survival in lymph node positive cases. Sentinel lymph node dissection has no negative effect on survival in lymph node positive patients.