Survival disparities in women with endometrial cancer based on metastasis size in the sentinel lymph node: A tertiary cancer centre observational cohort study
The adoption of sentinel lymph node (SLN)-mapping with ultrastaging for patients with endometrial cancer has led to increased rates of metastatic nodal disease due to the detection of low-volume metastases (LVM), i.e. micrometastasis and isolated tumour cells (ITCs). Exploring their association with survival can aid risk stratification and personalised treatment approaches. To evaluate disease-free and disease-specific survival based on SLN metastasis size in patients with endometrial cancer. This observational cohort study included patients with endometrial cancer who underwent robot assisted laparoscopic (RAL) hysterectomy with SLN-mapping following the Memorial Sloan Kettering Cancer Center (MSKCC) algorithm between 2015-2024 at the Royal Marsden Hospital (RMH), a tertiary cancer institute in the United Kingdom (UK). Survival analyses employed Kaplan-Meier curves, logrank tests and Cox proportional hazard models, with endpoints being disease-specific and overall survival. 401 patients were included, with a mean BMI of 29.4 kg/m Patients with LVM in the SLN had similar survival outcomes to node-negative patients when treated with adjuvant therapy. Further prospective research is needed.