Mapping In Endometrial Cancer Research Articles

Sentinel node mapping in endometrial cancer.

Nodal status is one of the most important prognostic factors for patients with apparent early stage endometrial cancer. The role of retroperitoneal staging in endometrial cancer is controversial. Nodal status provides useful prognostic data, and allows to tailor the need of postoperative treatments. However, two independent randomized trials showed that the execution of (pelvic) lymphadenectomy increases the risk of having surgery-related complication without improving patients' outcomes. Sentinel node mapping aims to achieve data regarding nodal status without increasing morbidity. Sentinel node mapping is the removal of first (clinically negative) lymph nodes draining the uterus. Several studies suggested that sentinel node mapping is not inferior to lymphadenectomy in identifying patients with nodal disease. More importantly, thorough ultrastaging sentinel node mapping allows the detection of low volume disease (micrometastases and isolated tumor cells), that are not always detectable via conventional pathological examination. Therefore, the adoption of sentinel node mapping guarantees a higher identification of patients with nodal disease than lymphadenectomy. Further evidence is needed to assess the value of various adjuvant strategies in patients with low volume disease and to tailor those treatments also on the basis of the molecular and genomic characterization of endometrial tumors.

Real-World Data Assessing the Impact of Lymphovascular Space Invasion on the Diagnostic Performance of Sentinel Lymph Node Mapping in Endometrial Cancer.

SLN mapping has emerged as a standard of care in endometrial cancer due to its high sensitivity and significant reduction in morbidity. Although lymphovascular space invasion (LVSI) is a known risk factor for lymph node metastasis and recurrence, evidence on the reliability of SLN mapping in LVSI-positive patients is scarce. The aim of this study was to determine the impact of LVSI on the diagnostic performance of SLN mapping. This retrospective cohort study included patients with endometrial cancer who underwent primary surgical treatment at the Bern University Hospital, Switzerland, between 2012 and 2022. LVSI was present in 22% of patients and was significantly associated with lymph node metastasis (p < 0.001) and recurrence (p < 0.001). In node-negative patients with only SLN mapping performed, LVSI was an independent predictor of recurrence during multivariable Cox regression analysis (p = 0.036). The negative predictive value of SLN mapping was 91.5% and was significantly lower in tumors with LVSI (75.0%) compared to LVSI-negative tumors (95.6%, p = 0.004). The presence of LVSI was significantly associated with worse oncological outcomes. LVSI was an independent predictor of recurrence in node-negative patients with only SLN mapping performed. Furthermore, the negative predictive value of SLN mapping was significantly lower in LVSI-positive tumors.

Let go of the myth: safety of indocyanine green for sentinel lymph node mapping in endometrial cancer

ObjectiveSentinel lymph node mapping by intracervical indocyanine green injection is the preferred method for surgical staging in endometrial cancer. Adverse reactions to indocyanine green are extremely rare, and information about...

Sentinel lymph node mapping in endometrial cancer: Current evidence and practice.

Surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, and lymph node assessment is the standard of care for patients with clinical early-stage endometrial cancer. Traditionally, complete pelvic and para-aortic lymphadenectomy (LND) was performed to assess for nodal metastases; however, numerous prospective studies have demonstrated that sentinel lymph node biopsy has similar diagnostic accuracy, and is an acceptable alternative to complete LND. This has led to a paradigm shift in endometrial cancer staging.

The progress and prospect of sentinel lymph node mapping in endometrial carcinoma

Sentinel lymph node (SLN) refers to the initial site of the lymphatic drainage from a primary tumor area. Identifying the SLN and analyzing tumor involvement can predict the status of the remaining lymph nodes. Accordingly, sentinel lymph node mapping (SLN mapping) has been brought up and widely applied to cancer therapy for its illuminating role in clinical lymph node resection. Sufficient information to guide surgical pathological staging and adjuvant treatment in endometrial cancer can be rendered by SLN mapping, hence minimizing surgery injury and reducing the incidence of complications. Evidence suggests that using SLN mapping does not affect progression-free survival (PFS) and overall survival (OS) of endometrial cancer patients. Furthermore, there is increasing evidence that using SLN mapping has a high detection rate (DR), sensitivity, and negative predictive value (NPV) for patients with early-stage lower-risk endometrial cancer. This review aims to systematically summarize the advances and application prospects of SLN mapping in endometrial cancer, with an expectation of furnishing reference for the clinical application.

Rolul ganglionului-santinelă în tratamentul actual al cancerului de endometru

Introduction. Endometrial cancer is the most prevailing gynecological malignancy in developed countries, with an incidence rising annually. For years, systematic lymphadenectomy had been the preferred method for staging purposes, but a less aggressive approach, with no negative impact on the oncologic outcomes, is the current trend in endometrial cancer management. In this review, we aim to evaluate the role of sentinel lymph node (SLN) mapping as an eligible alternative to complete pelvic lymphadenectomy in the surgical staging process, as well as its influence on the adjuvant treatment options. Materials and method. We analyzed the leading international guidelines regarding sentinel lymph node mapping in endometrial cancer, published between 2018 and 2023, as well as several studies that met the inclusion criteria, from the PubMed database, to outline the recommended surgical techniques, the algorithm, the accuracy, and the advantages of the SLN sampling procedure compared to pelvic lymphadenectomy. Results. Most international guidelines conclude that SLN sampling is the desirable alternative to systematic lymphadenectomy. However, it is agreed that, in case of failed SLN mapping, the radical option consisting in complete pelvic lymphadenectomy is recommended. As far as high-risk patients are concerned, most of the reviewed studies and guidelines encourage the use of SLN mapping in the treatment of endometrial cancer. Our findings revealed high sensitivity and detection rates of SLN mapping, influenced especially by the type of tracer used, indocyanine green having the best outcomes. Conclusions. Considering the high sensitivity and the low morbidity rates of the procedure, SLN mapping is soon to become a gold standard practice for the surgical staging process of endometrial cancer in many gynecologic oncology centers. Thus, SLN mapping represents a viable alternative to complete pelvic lymphadenectomy, acknowledging the principles of minimally invasive surgery and personalized medicine, without compromising the oncologic outcomes.

Sentinel lymph node mapping in endometrial cancer - robotic vs. laparoscopic detection system.

Comparison of systems to detect sentinel lymph node in endometrial carcinoma using indocyanine green. Robotic Firefly Da Vinci fluorescence imaging system (Intuitive Surgical Inc., Sunnyvale, CA, USA) vs. laparoscopic Novadaq Pinpoint near-infrared imaging system (Novadaq, Ontario, Canada). Fifteen patients with stage I endometrial cancer underwent sentinel lymph node biopsy after intracervical application of indocyanine green. For all of them, the detection was performed sequentially using both evaluated devices. The detection rate, identification match and extent of imaging of the lymphatic system were evaluated. The detection rate of both systems verified on a set of patients was identical, the detected sentinel nodes were identical, and the lymphatic system was shown to the same extent. The quality of the display and overall user-friendliness is different due to the applied technologies. Both systems used in minimally invasive surgery provide excelent perioperative imaging of the lymphatic system.

Abstract 2385: Targeting mannose receptor expression on macrophages for sentinel lymph node mapping in endometrial cancer: murine model

Abstract Background: Sentinel lymph node (SLN) mapping has been used in various cancer surgery including endometrial cancer as a targeted assessment tool for identifying lymph node metastases, an alternative for complete lymphadenectomy to minimize surgical morbidity. Neomannosyl human serum albumin (MSA) targets the macrophage mannose receptor CD206 which is highly expressed in metastatic lymph node. The aim of this study was to evaluate the effectiveness of indocyanine green-neomannosyl human serum albumin (MSA:ICG) which targets macrophage mannose receptor CD206 for SLN mapping. Methods: LN targeting ability was examined on mouse footpad models of uterine cancer using MSA:ICG and ICG for comparison. Seven mice with uterine cancer and 2 mice without cancer as a control group were each assigned to MSA:ICG and ICG groups. After injection of tracers, fluorescence images were taken and SLN biopsy was done to confirm LN metastasis status. We compared the signal-to-background ratio (SBR) according to time. Results: In both MSA:ICG and ICG group, 16 lymph nodes out of 18 were detected using fluorescence imaging (detection rate: 88.9%). Four lymph nodes in MSA:ICG group and 5 lymph nodes in ICG group were metastatic among 16 lymph node each group. Excluding lymph nodes that were not detected, the SBR after the injection of MSA:ICG group was significantly higher than ICG group in metastatic LN (MSA:ICG 4.36 vs ICG 3.07, p&amp;lt;0.001), non-metastatic lymph nodes (MSA:ICG 3.11 vs ICG 1.93, p=0.001), and normal control lymph nodes (MSA:ICG 1.38 vs ICG 0.54, p&amp;lt;0.001). Comparing signal intensity according to CD206 expression, there was no difference in SBR values between the two groups in patients without CD206 expression, but the MSA group had a statistically significantly higher SBR value than the ICG group (p&amp;lt;0.001) in patients with CD206 moderate or high expression. Conclusions: This study showed that MSA:ICG may be an effective tracer for sentinel lymph node mapping. In addition, the metastatic lymph nodes expressing CD206 showed higher signal than normal lymph nodes in MSA:ICG group, unlike in ICG group. Further studies using larger animal models and clinical trials are needed to confirm this result. Citation Format: Hyun-Woong Cho, OK Hwa Jeon, Sanghoon Lee, Hyun Koo Kim, Jae Kwan Lee, Jin Hwa Hong. Targeting mannose receptor expression on macrophages for sentinel lymph node mapping in endometrial cancer: murine model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2385.

Application of sentinel lymph node mapping in endometrial cancer: A survey among Chinese gynecological oncologists.

To gain a better understanding of the use of sentinel lymph node mapping by Chinese oncologists for endometrial cancer staging and analyze factors influencing its application. Questionnaires were collected online before and by phone after the symposium to evaluate the general characteristics of oncologists who participated in the endometrial cancer seminar and factors associated with the application of sentinel lymph node mapping in endometrial cancer patients. Gynecologic oncologists from 142 medical centers participated in the survey. 35.4% of doctors employed sentinel lymph node mapping for endometrial cancer staging, 57.3% chose indocyanine green as the tracer. Multivariate analysis revealed that cancer research center (odds ratio=4.229, 95% CI 1.747-10.237), physician familiarity with sentinel lymph node mapping (odds ratio=126.188, 95% confidence interval 43.220-368.425) and the use of ultrastaging (odds ratio=2.657, 95% confidence interval 1.085-6.506) were related to the doctors' selection of sentinel lymph node mapping. There was a significant difference in the surgical procedure for early endometrial cancer, the number of removed sentinel lymph node, and the reason for not adopting sentinel lymph node mapping before and after the symposium. The theoretical knowledge of sentinel lymph node mapping, the use of ultrastaging, and cancer research center are related to a higher acceptance of sentinel lymph node mapping. Distance learning is conducive to the promotion of this technology.

Hysterectomy alone vs. hysterectomy plus sentinel node mapping in endometrial cancer: Perioperative and long-term results from a propensity-score based study

ObjectiveTo compare outcomes after hysterectomy and hysterectomy plus sentinel node mapping (SNM) in endometrial cancer (EC) patients. Materials and methodsThis is a retrospective study, collecting data of EC patients treated between 2006 and 2016 in nine referral centers. ResultsThe study population included 398 (69.5%) and 174 (30.5%) patients having hysterectomy and hysterectomy plus SNM. As the results of the adoption of a propensity-score matched analysis, we selected two homogeneous cohort of patients (150 having hysterectomy only vs. 150 having hysterectomy plus SNM). The SNM group had a longer operative time, but did not correlate with length of hospital stay and estimated blood loss. Overall severe complication rates were similar between groups (0.7% in the hysterectomy group vs. 1.3% in the hysterectomy plus SNM group; p = 0.561). No lymphatic-specific complication occurred. Overall, 12.6% of patients having SNM were diagnosed with disease harboring in their lymph nodes. Adjuvant therapy administration rate was similar between groups. Considering patients having SNM, 4% of patients received adjuvant therapy on the basis of nodal status alone; all the other patients received adjuvant therapy also on the basis of uterine risk factors. Five-year disease-free (p = 0.720) and overall (p = 0.632) survival was not influenced by surgical approach. ConclusionsHysterectomy (with or without SNM) is a safe and effective method for managing EC patients. Potentially, these data support the omission of side specific lymphadenectomy in case of unsuccessful mapping. Further evidence is warranted in to confirm the role SNM in the era of molecular/genomic profiling.

Personalized Sentinel Node Mapping in Endometrial Cancer by the Indocyanine Green Implementation as Single Tracer: A Case Control Study.

The main objective was to analyze the rate of bilateral sentinel lymph node (SLN) detection in endometrial cancer using indocyanine green (ICG) as a unique tracer compared to Technetium99 + ICG. As secondary objectives, we analyzed the drainage pattern and factors that might affect the oncological outcomes. A case-control ambispective study was carried out on consecutive patients at our center. Data on the SLN biopsy with ICG collected prospectively were compared to retrospective data on the use of a double-tracer technique including Technetium99 + ICG. In total, 194 patients were enrolled and assigned to both groups, in which the group with both tracers (controls) included 107 (54.9%) patients and the ICG-alone group (cases) included 87 (45.1%) patients. The rate of bilateral drainage was significantly higher in the ICG group (98.9% vs. 89.7%; p = 0.013). The median number of nodes retrieved was higher in the control group (three vs. two nodes; p < 0.01). We did not find survival differences associated with the tracer used (p = 0.85). We showed significant differences in terms of disease-free survival regarding the SLN location (p < 0.01), and obturator fossa retrieved nodes showed better prognosis compared to external iliac. The use of ICG as a single tracer for SLN detection in endometrial cancer patients seemed to obtain higher rates of bilateral detection with similar oncological outcomes.

Hysterectomy Alone vs. Hysterectomy Plus Sentinel Node Mapping in Endometrial Cancer: Long-Term Results from a Multi-Institutional Study

<h3>Study Objective</h3> To compare perioperative and long-term outcomes after hysterectomy and hysterectomy plus sentinel node mapping (SNM) in endometrial cancer (EC) patients. <h3>Design</h3> This is a multi-institutional retrospective study. <h3>Setting</h3> Oncologic referral centers. <h3>Patients or Participants</h3> Patients with apparent early-stage EC. <h3>Interventions</h3> Laparoscopic surgical staging. <h3>Measurements and Main Results</h3> Charts of 572 consecutive EC patients were evaluated. The study population included 398 (69.5%) and 174 (30.5%) patients having laparoscopic hysterectomy and laparoscopic hysterectomy plus SNM. As the results of the adoption of a propensity-score matched analysis, we selected two homogeneous cohort of patients (150 having hysterectomy only vs. 150 having hysterectomy plus SNM). The execution of sentinel node mapping correlated with longer operative time, but it is not influencing length of hospital stay and estimated blood loss. Overall complication rates were similar between groups (0.7% in the hysterectomy group vs. 1.3% in the hysterectomy plus SNM group; p=0.561). No lymphatic-specific complication occurred. Overall, 12% of patients having SNM were diagnosed with disease harboring in their lymph nodes. While no stage IIIC patients were diagnosed among patients having hysterectomy only. Considering patients diagnosed with stage IIIC disease, we observed that macrometastais, micrometastasis, and isolated tumor cells were detected in 9 (6%), 3 (2%), and 6 (4%) patients, respectively. Adjuvant therapy administration rate was similar between groups. Considering patients having SNM, less than 5% of patients received adjuvant therapy on the basis of nodal status only; all the other patients received adjuvant therapy on the basis of uterine risk factors. In comparison to hysterectomy alone, SNM did not improve disease-free survival in low- (p=0.789), intermediate- (p=0.850), and high-risk patients (p=0.540, log-rank test). Five-year overall survival was not influenced by surgical approach. <h3>Conclusion</h3> Laparoscopic hysterectomy (with or without SNM) is safe and effective method for managing EC patients. Further evidence is warranted in to confirm whether SNM could be safely omitted in the era of molecular/genomic profiling.

Clinical factors associated with failed sentinel lymph node mapping in endometrial cancer

ObjectiveSentinel lymph node (SLN) mapping is a highly accurate surgical technique for detecting metastases in endometrial cancer. The objective of this study was to identify clinical factors associated with failed mapping. MethodsAll patients with endometrial cancer undergoing minimally-invasive staging and planned SLN biopsy from 1/1/2017 to 12/31/2020 at a single institution were identified retrospectively. Demographic, clinicopathologic and treatment data were obtained. Data were compared using descriptive statistics. Univariate and multivariable logistic regression were performed to identify predictors of failed mapping. Results819 patients were identified with a mean age of 64.6 years (range 26–93) and mean BMI of 35.6 kg/m2 (range 18–68). Most (88.5 %, 725/819) had early-stage disease and endometrioid histology (82.3 %, 674/819). A majority (74.2 %, 608/819) had successful bilateral mapping, and 54 (6.6 %) had unsuccessful bilateral mapping. Increasing BMI was significantly associated with unsuccessful bilateral mapping: patients with BMI > 30 were more likely to have unsuccessful SLN mapping (p = 0.033). Among patients with known lymph node status (799/819), patients with macrometastases and micrometastases were more likely to have failed bilateral mapping compared to those with negative SLNs or isolated tumor cells (p = 0.013). On multivariable analysis, higher BMI and histology were associated with failed bilateral mapping (OR = 1.023, 95 % CI (1.005, 1.041) and OR = 1.678, 95 % CI (1.177, 2.394), respectively). ConclusionSLN mapping has a high success in patients undergoing minimally-invasive surgical staging for endometrial cancer. Increasing BMI, high risk histology, and lymph node metastases are risk factors for failed mapping.

Structure of Hyperplastic Processes of the Uterus in Menopausal Women According to the Results of an Echographic Study

The purpose of the study was to evaluate the results of ultrasound scanning in menopausal women with endometrial hyperplastic processes. Materials and methods. Ultrasound protocols of 67 menopausal women with uterine hyperplastic processes were analyzed. Endometrial imaging data were assessed as corresponding to focal endometrial hyperplasia in 53 (79.1%) women. Uterine fibroids in combination with endometrial hyperplasia were found in 42 (62.7%) menopausal patients. According to the transvaginal ultrasound protocols, only endometrial polyp was detected in 20.9% of women (n=14). Results and discussion. The main complaints of patients with endometrial hyperplastic processes were abnormal uterine bleeding and abdominal pain. Every third (n=22; 32.8%) woman in the menopausal period noted uterine bleeding. Every second patient complained of lower abdominal pain of varying intensity (n=34; 50.7%). 11 (16.4%) women had no complaints. All the women studied underwent transvaginal and transabdominal ultrasound (in 3D mode). Ultrasound examination of the pelvic organs in order to differentiate endometrial pathology in 54% of cases was performed twice and more often. Ultrasound examination of the uterus was performed in standard projections. Endometrial polyps in most cases were oval in shape and were visualized quite clearly due to high echogenicity, homogeneous structure, the presence of a base that has no connection with the myometrium, and the integrity of the basal layer in the area of attachment of the polyp base. The sizes of endometrial polyps ranged from 1 mm to 90 mm (12.6 ± 3.5 mm). Small polyps were more often of increased echogenicity and homogeneous structure. At the same time, patients with endometrial polyps in the menopausal period often lack their visualization during transvaginal ultrasound. They are often verified as a focal or diffuse form of endometrial hyperplasia, while the low frequency of diagnosis of polyps in the menopausal period is determined. Ultrasound results were interpreted as corresponding to a combination of focal hyperplasia and endometrial polyp in 16.4% of cases (n=11). Ultrasound with color Doppler mapping in endometrial cancer revealed a sharp increase in the blood flow rate in the arсuate arteries (Vmax = 0.33 ± 0.06 m/s, Vmin = 0.16 ± 0.1 m/s). Conclusion. Ultrasound is an affordable method for diagnosing hyperplastic processes of the uterus. In the diagnosis and determination of the structure of hyperplastic processes of the uterus, combined transabdominal and transvaginal ultrasound is a highly informative non-invasive method. There is a need for further investigation of the management tactics of patients with endometrial pathology during menopause

Clinical factors associated with failed sentinel lymph node mapping in endometrial cancer (527)

Clinical factors associated with failed sentinel lymph node mapping in endometrial cancer (527)

Sentinel lymph node mapping in endometrial cancer: an updated review

Sentinel lymph node mapping in endometrial cancer: an updated review

Sentinel lymph node mapping in endometrial cancer: A comparison of main national and international guidelines.

To compare national and international guidelines regarding sentinel lymph node (SLN) mapping in endometrial cancer. A descriptive comparative study of the National Comprehensive Cancer Network (NCCN), the Society of Gynecologic Oncology (SGO), the European Society of Gynecological Oncology (ESGO), the British Gynecological Cancer Society (BGCS), and the Japan Society of Gynecologic Oncology (JSGO) guidelines. There is a broad consensus that SLN mapping is an appropriate alternative to pelvic lymphadenectomy for uterine-confined endometrioid endometrial cancer (five of five guidelines). It is broadly accepted that a full lymphadenectomy should be performed in case of failed SLN mapping (four of five guidelines), and that mapping with the fluorescent dye indocyanine green is superior to other methods (four of five guidelines). It is agreed that the cervix is the preferable site for dye injection (four of five guidelines), and pathology ultrastaging is advocated by most guidelines (three of five guidelines). Regarding high-risk patients (i.e., high-grade histology and non-endometroid carcinomas), some guidelines accept (three of five), but others currently do not advocate (one of five guidelines), SLN mapping as a sole method for lymph node evaluation. There is no consensus regarding para-aortic lymph node evaluation in pelvic SLN-positive patients. Guidelines for SLN mapping are comparable with regards to surgical technique, ultrastaging, and management in case of failed mapping. Nevertheless, some variations exist regarding the management of high-grade histology and positive pelvic lymph nodes.

115 Surgical technique: indocyanine green and infrared fluorescence in sentinel lymph node mapping in endometrial cancer

Introduction: Endometrial cancer (EC) is the most common gynecological cancer in Europe and its incidence is increasing with aging population and obesity. Methods: We present a video describing the technical aspects of laparoscopic sentinel lymph node (SLN) biopsy using indocyanine green (ICG) and near-infrared fluorescence in FIGO stage IA endometrioid, low-grade EC, as part of the ongoing clinical trial at the author’s department regarding the use of SLN biopsy in EC. Results: A 72 year-old asymptomatic patient presented with a thickened endometrial lining on routine gynecological ultrasound and was diagnosed with endometrioid, low-grade EC on hysteroscopic endometrial biopsy.

Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer.

Sentinel lymph node (SLN) mapping is becoming an acceptable alternative to full lymphadenectomy for evaluating lymphatic spread in clinical stage I endometrial cancer (EC). While the assessment of pelvic and para-aortic lymph nodes is part of the surgical staging of EC, there is a long-standing debate over the therapeutic value of full lymphadenectomy in this setting. Although lymphadenectomy offers critical information on lymphatic spread and prognosis, most patients will not derive oncologic benefit from this procedure as the majority of patients do not have lymph node involvement. SLN mapping offers prognostic information while simultaneously avoiding the morbidity associated with an extensive and often unnecessary lymphadenectomy. A key factor in the decision making when planning for EC surgery is the histologic subtype. Since the risk of lymphatic spread is less than 5% in low-grade EC, these patients might not benefit from lymph node assessment. Nonetheless, in high-grade EC, the risk for lymph node metastases is much higher (20–30%); therefore, it is crucial to determine the spread of disease both for determining prognosis and for tailoring the appropriate adjuvant treatment. Studies on the accuracy of SLN mapping in high-grade EC have shown a detection rate of over 90%. The available evidence supports adopting the SLN approach as an accurate method for surgical staging. However, there is a paucity of prospective data on the long-term oncologic outcome for patients undergoing SLN mapping in high-grade EC, and more trials are warranted to answer this question.

Sentinel lymph node mapping in endometrial cancer to reduce surgical morbidity: always, sometimes, or never

IntroductionSurgical staging of nodal status is of utmost significance to determine the stage of endometrial cancer and construct a targeted treatment plan. Systematic lymphadenectomy has for years been the procedure of choice for staging purposes, enabling thorough assessment of lymph nodes. Nevertheless, it is associated with increased morbidity and severe postoperative complications. In an attempt to avoid the disadvantages of lymphadenectomy, the use of sentinel lymph node (SLN) biopsy has been examined as an alternative staging procedure.The purpose of the present review is to summarize and provide up-to-date evidence about the role of SLN biopsy in the staging and management of endometrial cancer cases in the terms of optimal technique, efficacy, safety, and postoperative morbidity, as an alternative approach to regional lymphadenectomy.Material and methodsA thorough literature search was conducted in MEDLINE and SCOPUS to identify recent primary research and previous review articles that explore the use of SLN mapping as a staging procedure in patients with endometrial cancer.ResultsThere is increasing evidence that SLN mapping is efficient in identifying metastatic nodal disease without compromising oncological safety, achieving comparable or even superior detection rates to those of lymphadenectomy, when optimal technique and careful intraoperative nodal assessment are applied.ConclusionsSentinel lymph node mapping can safely replace lymphadenectomy as an acceptable alternative staging method for endometrial cancer; however, future research might further strengthen this suggestion by resolving potential areas of doubt and debate, especially for high-risk endometrial cancer cases.