SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1584447
Long-term outcomes in patients with endometrial cancer after sentinel lymph node biopsy versus lymphadenectomy alone: a meta-analysis
Provisionally accepted
- General Hospital of Xuzhou Mining Group, Xuzhou, China
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AbstractObjective: This study aimed to assess the prognosis of endometrial cancer (EC) patients after sentinel lymph node biopsy (SLNB) or lymph node dissection (LND) alone.Methods: 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.Results: 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).Conclusion: 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.
Keywords: endometrial cancer, Sentinel Lymph Node Biopsy, Lymphadenectomy, Oncological outcome, overall survival, Progression free survival, Disease specific survival
Received: 27 Feb 2025; Accepted: 28 Apr 2025.
Copyright: © 2025 Zhang, Zheng and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dandan Zhu, General Hospital of Xuzhou Mining Group, Xuzhou, China
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