PMID- 36334496 OWN - NLM STAT- MEDLINE DCOM- 20221230 LR - 20240102 IS - 1095-6859 (Electronic) IS - 0090-8258 (Print) IS - 0090-8258 (Linking) VI - 168 DP - 2023 Jan TI - Sentinel lymph node mapping in patients with endometrial hyperplasia: A practice to preserve or abandon? PG - 1-7 LID - S0090-8258(22)01894-7 [pii] LID - 10.1016/j.ygyno.2022.10.017 [doi] AB - OBJECTIVES: To compare outcomes of patients with premalignant endometrial pathology undergoing hysterectomy with or without sentinel lymph node (SLN) removal. Outcomes of interest included surgical adverse events (AEs), cancer status on final pathology, postoperative treatment, and The Cancer Genome Atlas (TCGA) molecular risk profiles. METHODS: We retrospectively identified patients with premalignant pathology on preoperative endometrial biopsy who underwent hysterectomy with or without SLN mapping/excision at our institution from 01/01/2017-12/31/2021. Clinical, pathologic, surgical, and TCGA profiling data were abstracted. Appropriate statistical tests were used. RESULTS: Of 221 patients identified, 161 (73%) underwent hysterectomy with SLN excision and 60 (27%) underwent hysterectomy without SLN excision. Median age and body mass index were similar between groups. Median operative time was 130 min for those who underwent SLN mapping/excision versus 136 min for those who did not (p = 0.6). Thirty-day postoperative AE rates were 9% (n = 15/161) and 13% (n = 8/60), respectively (p = 0.9). Ninety-eight (44%) of 221 patients had grade 1-2 endometrioid endometrial cancer on final pathology (4 [4%] were stage IB or higher). Ten (10%) of 98 patients, all within the SLN group, received adjuvant treatment. Among all patients, of 33 (15%) with TCGA molecular classification data, 27 (82%) had copy number-low, 3 (9%) microsatellite instability-high, 2 (6%) POLE-ultramutated, and 1 (3%) copy number-high disease. CONCLUSIONS: SLN assessment appears safe, detects a small number of occult nodal metastases for those upstaged, and provides additional staging information that can guide adjuvant treatment. SLN mapping should be discussed in preoperative counseling and offered using a shared decision-making approach. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Mueller, Jennifer J AU - Mueller JJ AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. Electronic address: muellerj@mskcc.org. FAU - Rios-Doria, Eric AU - Rios-Doria E AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. FAU - Park, Kay J AU - Park KJ AD - Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. FAU - Broach, Vance A AU - Broach VA AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. FAU - Alektiar, Kaled M AU - Alektiar KM AD - Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. FAU - Jewell, Elizabeth L AU - Jewell EL AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. FAU - Zivanovic, Oliver AU - Zivanovic O AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. FAU - Sonoda, Yukio AU - Sonoda Y AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. FAU - Abu-Rustum, Nadeem R AU - Abu-Rustum NR AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. FAU - Leitao, Mario M Jr AU - Leitao MM Jr AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. FAU - Gardner, Ginger J AU - Gardner GJ AD - Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA. LA - eng GR - P30 CA008748/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20221102 PL - United States TA - Gynecol Oncol JT - Gynecologic oncology JID - 0365304 SB - IM MH - Female MH - Humans MH - Sentinel Lymph Node Biopsy MH - *Sentinel Lymph Node/surgery/pathology MH - *Endometrial Neoplasms/genetics/surgery/diagnosis MH - Retrospective Studies MH - *Endometrial Hyperplasia/surgery/pathology MH - Lymph Nodes/surgery/pathology MH - Lymph Node Excision MH - *Carcinoma, Endometrioid/pathology MH - Neoplasm Staging PMC - PMC10184678 MID - NIHMS1897128 OTO - NOTNLM OT - Endometrial cancer OT - Endometrial hyperplasia OT - Hysterectomy OT - Sentinel lymph node COIS- Declaration of Competing Interest Outside the submitted work, Dr. Jewell reports personal fee from Covidien/Medtronic; Dr. Abu-Rustum reports grant money from GRAIL paid to the institution; and Dr. Leitao reports personal fees from Medtronic, Intuitive Surgical, Inc., and JnJ/Ethicon. EDAT- 2022/11/06 06:00 MHDA- 2022/12/31 06:00 PMCR- 2024/01/01 CRDT- 2022/11/05 19:21 PHST- 2022/07/25 00:00 [received] PHST- 2022/10/12 00:00 [revised] PHST- 2022/10/18 00:00 [accepted] PHST- 2022/11/06 06:00 [pubmed] PHST- 2022/12/31 06:00 [medline] PHST- 2022/11/05 19:21 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - S0090-8258(22)01894-7 [pii] AID - 10.1016/j.ygyno.2022.10.017 [doi] PST - ppublish SO - Gynecol Oncol. 2023 Jan;168:1-7. doi: 10.1016/j.ygyno.2022.10.017. Epub 2022 Nov 2.