Oncological safety and perioperative morbidity in low-risk endometrial cancer with sentinel lymph-node dissection.

Imboden, Sara; Mereu, Liliana; Siegenthaler, Franziska; Pellegrini, Alice; Papadia, Andrea; Tateo, Saverio; Mueller, Michael D. (2019). Oncological safety and perioperative morbidity in low-risk endometrial cancer with sentinel lymph-node dissection. European journal of surgical oncology EJSO, 45(9), pp. 1638-1643. Elsevier 10.1016/j.ejso.2019.05.026

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BACKGROUND and Purpose: In endometrial cancer, staging is performed surgically. Controversy about the required extent of lymph node removal is ongoing. In low-risk endometrial cancer (FIGO Stage 1, endometrioid histology, Grades 1 and 2), the risk of lymph-node involvement is 4-17%. Since the introduction of near-infrared optics and the use of indocyanine green, the role of sentinel lymph node removal is increasing and could offer an appropriate balance between the morbidity of a complete lymph-node dissection and the risk of missing lymph-node involvement. METHODS In this retrospective comparative study on low-risk endometrial cancer, the extent of surgical lymph-node assessment (no lymphadenectomy vs removal vs lymphadenectomy) in two European institutions was compared and analyzed on the basis of perioperative data and oncological outcome. RESULTS The study included 279 patients from: 103 (36.9%) had no lymphadenectomy, 118 (42.3%) underwent SLN removal and 58 (20.8%) underwent pelvic and/or para-aortic lymphadenectomy. There were significant differences among the groups in blood loss (p = 0.000), operation time (p = 0.000), and severity of postoperative complications (p = 0.063). In comparing only sentinel lymph-node removal vs no lymphadenectomy, there were no significant differences. No significant difference was seen between the extent of lymphadenectomy removal and the risk of recurrence. Age and Lymphovascular space invasion positivity were significant risk factors for recurrence (p = 0.004 and p = 0.019). CONCLUSIONS In early-stage, endometrial cancer, Grade 1 and 2, sentinel lymph node removal offers a convincing balance between oncological safety and perioperative morbidity. Especially in LVSI-positive cases, lymph-node evaluation in any form is crucial.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Imboden, Sara; Siegenthaler, Franziska Anna; Papadia, Andrea and Mueller, Michael


600 Technology > 610 Medicine & health








Monika Zehr

Date Deposited:

24 Dec 2019 09:56

Last Modified:

24 Dec 2019 09:56

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Endometrial cancer ICG Lymph-node dissection Oncological safety Perioperative morbidity Sentinel





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