Sentinel lymph node mapping in endometrial cancer: time for a change

Since the publication of the results of the clinic-pathological study GOG #33, staging for endometrial cancer changed from clinical to surgical and required a pelvic and para-aortic lymphadenectomy (1,2). Since then, the role of the pelvic and para-aortic lymphadenectomy has been widely debated. In patients with non-bulky lymph nodes, the lymphadenectomy plays a staging role. Since the risk of lymph nodal metastases varies in endometrial cancer patients and is particularly low in patients with small, well differentiated and superficially invasive lesions, several authors believe that the routine performance of a full pelvic and para-aortic lymphadenectomy is not useful and should be avoided in a specific subgroup of endometrial cancer patients (3).