A newer perspective in the surgical approach to endometrial cancer: Sentinel lymph node evaluation

In recent years sentinel lymph node mapping has emerged as an attractive approach for the treatment of endometrial cancer (EC). Its feasibility in early-stage disease has been confirmed by several studies, although it is not clear which is the best mapping technique and injection site of tracer. Recent studies have shown that a radical lymphadenectomy (LND) may have no therapeutic benefit in patients with early-stage EC; subsequently, SLN mapping may decrease lymph node dissections where unnecessary. The recent introduction of ultrastaging in the pathological evaluation of lymph nodes has improved the rate detection of low volume metastases but the prognostic significance of these findings is still unclear, and the optimal postsurgical management for these patients has not yet been identified. This chapter, through the analysis of available literature, provide an update on the role of sentinel lymph node evaluation in EC.