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Sentinel Lymph Node Mapping in Patients with Endometrial Carcinoma: Less Can Be More

  • Gynecologic Oncology (C Feltmate, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The role and extent of lymphadenectomy for endometrial carcinoma has been debated for over 30 years. Many clinicians argue that there is therapeutic value for lymphadenectomy in patients deemed to be “at risk,” a designation not universally defined, despite the lack of randomized data supporting this argument. However, lymphadenectomy is associated with morbidity, including lower extremity lymphedema. Sentinel lymph node (SLN) mapping is emerging as a viable alternative to comprehensive lymphadenectomy in the surgical staging of patients with endometrial cancer.

Recent Findings

Nodal disease status is an important prognostic and predictive factor. Surgical staging with lymphadenectomy remains an important part of the treatment of patients with newly diagnosed endometrial carcinoma despite the dispute regarding its therapeutic value. Many clinicians have argued for abandoning lymphadenectomy altogether; however, this too is not ideal, as it may lead to undertreatment due to inadequate staging or overtreatment with toxic therapies.

Summary

SLN mapping has emerged as a viable compromise between a comprehensive lymphadenectomy and no lymph node sampling in the surgical staging of these patients and may lead to reduced morbidity risks. In this review, we present the currently available data in this area of research, as well as our experience with SLN mapping.

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Authors and Affiliations

  1. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Mario M. Leitao Jr

  2. Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY, USA

    Mario M. Leitao Jr

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  1. Mario M. Leitao Jr
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Correspondence to Mario M. Leitao Jr.

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Conflict of Interest

Mario M. Leitao, Jr. declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding

This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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This article is part of the Topical Collection on Gynecologic Oncology

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Leitao, M.M. Sentinel Lymph Node Mapping in Patients with Endometrial Carcinoma: Less Can Be More. Curr Obstet Gynecol Rep 5, 279–285 (2016). https://doi.org/10.1007/s13669-016-0178-7

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  • DOI: https://doi.org/10.1007/s13669-016-0178-7

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