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Patients receiving primary systemic or chemoradiation therapy were excluded. Patient characteristics and treatment details were analyzed descriptively and stratified by year of surgery. This multicenter retrospective cohort study was conducted as part of the E-PEC project, an ethics-approved multicenter project assessing surgical management patterns in newly diagnosed endometrial cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 644 patients met the inclusion criteria. Overall, 62.4% underwent lymph node surgery. Sentinel-based procedures were increasingly performed over time and accounted for 61.4% of all nodal staging procedures. In contrast, the rate of primary systematic lymphadenectomy significantly decreased from 30.3% in 2018 to 17.9% in 2022 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed a temporal increase in less radical lymph node procedures in selected German academic centers during the study period. Sentinel-based techniques were increasingly used over time in parallel with evolving guideline recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08514-z","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:14:29Z","timestamp":1785255269000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolving paradigms in lymph node surgery in endometrial cancer: insights from the multicenter E-PEC trial"],"prefix":"10.1007","volume":"313","author":[{"given":"B.","family":"Eser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Papior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Salmanton-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. 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Buderath P: Adboard\/lecture fees from Genmab, AstraZeneca, MSD, GSK. Cornely O A: OAC reports grants or contracts from iMi, iHi, DFG, BMBF, Cidara, DZIF, EU-DG RTD, F2G, Gilead, MedPace, MSD, Mundipharma, Octapharma, Pfizer, Scynexis; Consulting fees from Abbvie, AiCuris, Basilea, Biocon, Boston Strategic Partners, Cidara, Elion Therapeutics, Gilead, GSK, IQVIA, Janssen, Matinas, MedPace, Menarini, Melinta, Molecular Partners, Mundipharma, Noxxon, Octapharma, Pardes, Pfizer, PSI, Scynexis, Seres, Seqirus, Shionogi, The Prime Meridian Group; Speaker and lecture honoraria from Abbott, Abbvie, Al-Jazeera Pharmaceuticals\/Hikma, Amedes, AstraZeneca, Gilead, GSK, Grupo Biotoscana\/United Medical\/Knight, InfectoPharm, Ipsen Pharma, Medscape\/WebMD, MedUpdate, MSD, Moderna, Mundipharma, Noscendo, Paul-Martini-Stiftung, Pfizer, Sandoz, Seqirus, Shionogi, streamedup!, Touch Independent, Vitis; Participation on a DRC, DSMB, DMC, Advisory Board for AstraZeneca, Cidara, IQVIA, Janssen, MedPace, Melinta, PSI, Pulmocide, Vedanta Biosciences. Kimmig R: Proctoring, Advisory Board, Presentations, Travel support: Intuitive Surgical, Medtronic, Avatera, CMR Surgical, Active Surgical, Cava Robotics, Novocure, Medicaroid, GSK, MSD, Astra-Zeneca. Radosa J: Honoraria\/consultancy work\/research funding\/expert testimony\/travel support: Pfizer, Eisai, MSD, Roche, Novartis, Gedeon Richter, Lilly, Pierre Fabre, Daichi Sankyo, Medac GmbH, Seagen Radosa J C: Honoraria\/Consulting: Pfizer, Eisai, MSD, Roche, Novartis, Gedeon Richter, Lilly, Pierre Fabre, Daiichi Sankyo, Clovis, Stemline, AstraZeneca, Theramex, Seagen, Exact Sciences; Travel support: Medac GmbH, Daiichi Sankyo, Pfizer, Pierre Fabre, Seagen; Advisory board member: AGE, AGO TraFo Thangarajah F: Honorarium\/Consultancy work\/congress support\/travel support: Pierre Fabre, Astra Zeneca, MSD, Janssen, Lilly, Dyna Mesh, Intuitive, Distalmotion. Financial support of research: Marga- und Walter Boll Stiftung, CEFAM, GynOnko Stiftung, Stiftung Universit\u00e4tsmedizin Essen Weydandt L: Honoraria\/consultation fees from AstraZeneca, Lilly, Novartis, West German Study Group. The authors declare that these relationships have in no way influenced the conduct or results of the present work.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"237"}}