| Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India |
Kanika Batra Modi1 
, Arnika Kumari Kashyap1, Manvika Chandel1, Komal Agrawal2, Harit Kumar Chaturvedi3 |
1Department of Gynaecology Oncology, Max Super Speciality Hospital, Saket, India
2Department of Pathology, Max Super Speciality Hospital, Saket, India
3Department of Surgical Oncology, Max Super Speciality Hospital, Saket, India |
Correspondence:
Kanika Batra Modi,
Email: kanica.batra@gmail.com
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Received: 22 June 2024 • Revised: 4 October 2024 • Accepted: 11 December 2024 |
| Abstract |
Objective
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases. |
| Key Words:
Sentinel lymph node biopsy, Endometrial cancer risk, Adjuvant therapy endometrial cancer |
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