Review

Systematic lymphadenectomy or sentinel lymph node dissection in endometrial cancer: A clinical dilemma

Georgios Androutsopoulos1, Ioannis C. Kotsopoulos2, Porfyrios Korompelis2, Georgios Michail1, Georgios Adonakis1, Georgios Decavalas1

1Department of Obstetrics and Gynecology, University of Patras, Medical School, Rion, Greece
2Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, United Kingdom

Correspondence: Georgios Androutsopoulos MD, Ph.D, Assistant Professor, Department of Obstetrics and Gynecology, University of Patras, Medical School, Rion 26504, Greece, E-mail: androutsopoulos@upatras.gr, androutsopoulosgeorgios@hotmail.com


Abstract

Endometrial cancer represents a common malignancy of the female reproductive system and systematic surgical staging is the primary therapeutic approach, as offers many advantages in diagnosis, treatment and prognosis. Pelvic and para-aortic lymphadenectomy remains an integral part of the primary surgical therapeutic approach of endometrial cancer and provides substantial information concerning the need of postoperative adjuvant treatment, in order to improve survival, minimize side-effects and toxicity from over-treatment and avoid issues related to under-treatment. However, the extend of pelvic and para-aortic lymphadenectomy, has a direct correlation with the incidence of perioperative complications. Sentinel lymph node mapping and dissection constitutes a compromise between systematic and no lymphadenectomy especially in low or intermediate risk patients with endometrial cancer. It is a very popular and attractive approach in this patient subgroup and minimizes the incidence of perioperative complications compared to systematic lymphadenectomy. In conclusion, sentinel lymph node mapping and dissection still remains an experimental approach in patients with endometrial cancer, but it could possibly have a more important role in the assessment of pelvic and para-aortic lymph nodes and finally substitute systematic lymphadenectomy in the near future.

Keywords: systematic surgical staging, systematic lymphadenectomy, sentinel lymph node dissection, endometrial cancer

p. 14-19