However, studies have revealed that LAD may not be conducive to the prognosis of EC patients ( 2, 3). LAD represents a significant component of comprehensive staging for patients with EC. Surgery is the mainstay for treatment include total hysterectomy + bilateral salpingooophorectomy + pelvic lymphadenectomy +/− para-aortic lymphadenectomy (TH+BSO+PLAD+/−PALAD). In 2021, there will be an estimated 66,570 new cases and 12,940 deaths, making uterine cancer the second most prevalent cancer in women in U.S. This review aims at making a systematic description of the progress made in the application of SLNM in the treatment of EC and the relevant controversies, including the application of SLNM in high-risk patients.Įndometrial cancer (EC) is known as a common female genital malignancy with rapidly increasing incidence these years. As revealed by the recent studies, SLNM may also be feasible, effective, and safe in high-risk patients. However, the application of SLNM in early-stage high-risk EC patients remains controversial. Meanwhile, SLNM did not compromise the patient’s progression-free survival (PFS) and overall survival (OS) with low operative complications. Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node mapping (SLNM) with pathologic ultra-staging. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic metastasis of the primary malignant tumor through the regional lymphatic drainage pathway and can indicate the involvement of lymph nodes across the drainage area. However, conventional LAD shows high complication incidence and uncertain survival benefits. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2 (2) myometrial invasion< 1/2 (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. The incidence rate is on the increase annually. 2Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, ChinaĮndometrial cancer (EC) is known as a common gynecological malignancy.1Department of Gynecology and Obstetrics, Peking University People’s Hospital, Beijing, China.Lirong Zhai 1, Xiwen Zhang 2, Manhua Cui 2 and Jianliu Wang 1*
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