Sentinel node mapping (SLNM) has replaced lymphadenectomy for staging surgery in apparent early-stage endometrial cancer (EC). Here, we evaluate long-term survival of two different approaches of nodal assessment in EC. This is a multi-institutional retrospective study evaluating long-term outcomes (at least 3 years) of EC patients having SLNM alone and SLNM followed by lymphadenectomy. In order to reduce possible confounding factors we applied a propensity-matched algorithm. Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazard models. Three oncologic referral centers. Consecutive EC patients having minimally invasive surgical staging. Laparoscopic hysterectomy plus SLNM with or without backup lymphadenectomy. Applying a propensity score matching algorithm we selected 180 patients having SLNM (90 SLNM vs. 90 SLNM followed by lymphadenectomy). Median follow-up time was 69 months. Overall, 10% of patients were diagnosed with positive nodes. Low volume disease was observed in 16 cases (5 micrometastasis and 11 isolated tumor cells). Patients having SLNM followed by lymphadenectomy had not a higher possibility to be diagnosed with a stage IIIC disease in comparison to SLNM alone (p=0.389). The survival analysis comparing did not show statistical differences in terms of disease-free (p=0.570, log-rank test) and overall survival (p=0.911, log-rank test) were similar between groups. No survival differences were observed also after stratification in low, intermediate and high-risk patients (p>0.20). Our study highlighted that laparoscopic staging is safe and effective in EC. SLNM provides similar long-term oncologic outcomes than lymphadenectomy. Further evidence is warranted to assess the prognostic value of low-volume disease detected by ultra staging in patients following SLNM. [ABSTRACT FROM AUTHOR]
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