Sentinel Lymph Node Mapping in Presumed Low- and Intermediate-Risk Endometrial Cancer Management (SLIM): A Multicenter, Prospective Cohort Study in The Netherlands

Lara C Burg*, Roy F P M Kruitwagen, Annemarie de Jong, Johan Bulten, Tijmen J J Bonestroo, Arjan A Kraayenbrink, Dorry Boll, Sandrina Lambrechts, Huberdina P M Smedts, Annechien Bouman, Mirjam J A Engelen, Jenneke C Kasius, Ruud L M Bekkers, Petra L M Zusterzeel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The aim was to investigate the incidence of sentinel lymph node (SLN) metastases and the contribution of SLN mapping in presumed low- and intermediate-risk endometrial cancer (EC). A multicenter, prospective cohort study in presumed low- and intermediate-risk EC patients was performed. Patients underwent SLN mapping using cervical injections of indocyanine green and a minimally invasive hysterectomy with bilateral salpingo-oophorectomy. The primary outcome was the incidence of SLN metastases, leading to adjusted adjuvant treatment. Secondary outcomes were the SLN detection rate and the occurrence of complications. Descriptive statistics and univariate general linear model analyses were used. A total of 152 patients were enrolled, with overall and bilateral SLN detection rates of 91% and 61%, respectively. At final histology, 78.9% of patients (n = 120) had truly low- and intermediate-risk EC. Macro- and micro-metastases were present in 11.2% (n = 17/152), and three patients had isolated tumor cells (2.0%). Nine patients (5.9%) had addition of adjuvant radiotherapy based on SLN metastases only. In 2.0% of patients with high-risk disease, adjuvant therapy was more limited due to negative SLNs. This study emphasizes the importance of SLN mapping in presumed early-stage, grade 1 and 2 EC, leading to individualized adjuvant management, resulting in less undertreatment and overtreatment.

Original languageEnglish
Article number271
Number of pages15
JournalCancers
Volume15
Issue number1
DOIs
Publication statusPublished - Jan 2023

Fingerprint

Dive into the research topics of 'Sentinel Lymph Node Mapping in Presumed Low- and Intermediate-Risk Endometrial Cancer Management (SLIM): A Multicenter, Prospective Cohort Study in The Netherlands'. Together they form a unique fingerprint.

Cite this