# Long-term outcomes in patients with endometrial cancer after sentinel lymph node biopsy versus lymphadenectomy alone: a meta-analysis

## TL;DR

This study compares the long-term outcomes of endometrial cancer patients who underwent sentinel lymph node biopsy versus lymph node dissection and finds similar survival rates.

## Contribution

The study provides a meta-analysis showing that sentinel lymph node biopsy is a viable alternative to lymphadenectomy in endometrial cancer patients.

## Key findings

- No significant difference in overall survival between sentinel lymph node biopsy and lymphadenectomy.
- Sentinel lymph node biopsy showed better progression-free survival in certain subgroups.
- Further research is needed to confirm findings due to limitations in study design.

## Abstract

This study aimed to assess the prognosis of endometrial cancer (EC) patients after sentinel lymph node biopsy (SLNB) or lymph node dissection (LND) alone.

EMBASE, PUBMED, COCHRANE, and WEB of SCIENCE were thoroughly searched for relevant articles until October 2024. The outcomes of interest encompassed overall survival (OS), progression-free survival (PFS), and disease-specific survival (DSS). Data analysis was made in STATA 18.0. The Newcastle-Ottawa Scale tool was leveraged to appraise study quality.

13 studies were included, involving 36621 EC patients. No difference was revealed in OS between SLNB and LND (HR=1.04, 95%CI: 0.80–1.33; P=0.789). In subgroup analyses, the SLNB group from survival curves had worse OS (HR=1.63, 95%CI: 1.04-2.56; P=0.035); the SLNB group with intermediate- to high-risk EC had better OS (HR=0.20, 95%CI: 0.08-0.49; P<0.001). No difference was revealed in PFS between SLNB and LND (HR=0.99, 95%CI: 0.76–1.28; P=0.927). SLNB had better PFS in Asia (HR=0.44, 95% CI: 0.20-0.98, P=0.046) and stage I-III EC (HR=0.46, 95% CI: 0.24-0.89; P=0.021). No statistical difference was found in DSS (HR=3.18, 95%CI: 0.91-11.07; P=0.069).

SLNB is an effective alternative to conventional LND in either low- or intermediate-high-risk EC patients. However, due to the retrospective nature of most included studies and the limited data on high-risk patients, further prospective randomized controlled trials are warranted to validate these findings.

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024489323.