AI Article Synopsis
- Endometroid intraepithelial neoplasia (EIN) is a precancerous condition, and many gynecologic oncologists are considering sentinel lymph node (SLN) evaluation during hysterectomy to improve cancer staging.
- There is currently a lack of clear guidelines regarding the SLN evaluation for EIN patients, so the study assesses its advantages and disadvantages and offers an algorithm for better clinical application.
- While SLN evaluation can be safe and beneficial for high-risk cases, it may lead to overtreatment for most low-risk patients with EIN, signaling the need for careful patient selection based on risk factors and preoperative sampling.
Article Abstract
Introduction: Endometroid intraepithelial neoplasia (EIN) is a premalignant lesion to endometrial cancer. Increasing number of gynecologic oncologists are performing sentinel lymph node (SLN) evaluation during hysterectomy for EIN to ensure complete staging if there is cancer on the final specimen. However, there are no clear guidelines and the benefits and risks to performing SLN evaluation for EIN patients are unclear.
Areas Covered: This narrative review examines the advantages and disadvantages of SLN evaluation for EIN patients and provides an algorithm to assist clinicians in selectively applying the procedure for maximal patient benefit. Relevant articles up to March 2024 were obtained from a PubMed search on SLN use with endometrial pathology.
Expert Opinion: Sentinel lymph node evaluation for patients with EIN is safe, feasible, and particularly important for the approximately 10% of patients with high-risk endometrial carcinoma on final pathology. However, as most diagnosed carcinomas are low-risk, SLN evaluation would have limited oncologic benefit. While SLN assessment may overtreat most patients with EIN, a significant minority of patients will be improperly staged. We propose an algorithm highlighting the importance of maximal preoperative endometrial sampling and stratifying patients via risk factors to selectively identify those who would benefit most from SLN evaluation.
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| http://dx.doi.org/10.1080/14737140.2024.2372329 | DOI Listing |
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