{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:40:29Z","timestamp":1770813629984,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systematic pelvic lymph node dissection (PLND) is the conventional staging procedure for early-stage endometrial cancer but is associated with substantial morbidity, particularly lower-limb lymphedema. Sentinel lymph node biopsy (SLNB) is a less invasive alternative, yet real-world evidence on complications and patient-reported quality of life (QoL) remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare perioperative outcomes, postoperative complications, and QoL between SLNB and PLND in low- to intermediate-risk endometrial cancer, and to determine whether surgical approach is an independent risk factor for complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 150 eligible patients with early-stage endometrial cancer treated at a gynecologic oncology center between January 2020 and December 2023, with \u226512\u202fmonths of follow-up. Based on contemporaneously documented clinical decision-making and patient preference, patients were assigned to the SLNB group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f100) or the PLND group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f50). SLNB was performed using cervical indocyanine green injection with near-infrared fluorescence imaging; PLND comprised systematic pelvic lymphadenectomy. Outcomes included operative time, estimated blood loss, length of hospital stay, overall complications graded by Clavien\u2013Dindo, 12-month lymphedema incidence, SLN mapping success rate, lymph node pathology (including ultrastaging), and QoL assessed by the EORTC QLQ-C30 preoperatively and at 3, 6, and 12\u202fmonths. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for postoperative complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics (age, BMI, FIGO stage) were comparable between groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). Compared with PLND, SLNB was associated with shorter operative time (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), lower blood loss (p\u202f&amp;lt;\u202f0.001), and shorter postoperative hospital stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). The patient-level SLN mapping success rate was 97.0%. Overall complication rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and 12-month lymphedema incidence (p\u202f&amp;lt;\u202f0.001) were significantly lower in the SLNB group. Ultrastaging detected six additional cases of micrometastases or isolated tumor cells in the SLNB group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.016). Global health status scores were higher after SLNB at 3\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.007) and 6\u202fmonths (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.041). In multivariate analysis adjusting for age, BMI, diabetes, and FIGO stage, PLND remained an independent risk factor for postoperative complications (aOR 4.732; 95% CI 2.029\u201311.034;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In low- to intermediate-risk early-stage endometrial cancer, SLNB provides effective staging with reduced surgical burden, fewer postoperative complications\u2014particularly lymphedema\u2014and earlier recovery of QoL compared with systematic PLND.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1774295","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T07:03:34Z","timestamp":1770793414000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Complication rates and management in sentinel lymph node biopsy for endometrial cancer: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jing","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Gynecology, Hefei First People's Hospital","place":["Hefei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Hefei First People's Hospital","place":["Hefei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Hefei First People's Hospital","place":["Hefei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1001\/jamasurg.2020.5060","article-title":"Assessment of sentinel lymph node biopsy vs lymphadenectomy for intermediate- and high-grade endometrial Cancer staging","volume":"156","author":"Cusimano","year":"2021","journal-title":"JAMA Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"107956","DOI":"10.1016\/j.ejso.2024.107956","article-title":"Sentinel lymph node biopsy in endometrial cancer: when, how and in which patients","volume":"50","author":"Leone Roberti Maggiore","year":"2024","journal-title":"Eur J Surg Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/j.tjog.2024.05.003","article-title":"Sentinel-lymph-node mapping in endometrial cancer: tumor location matters?","volume":"63","author":"Liu","year":"2024","journal-title":"Taiwan J Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.3390\/curroncol29020096","article-title":"Sentinel lymph node mapping in high-grade endometrial Cancer","volume":"29","author":"Salman","year":"2022","journal-title":"Curr Oncol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1055\/s-0042-1749067","article-title":"Sentinel lymph node biopsy in endometrial Cancer - a systematic review and quality assessment of Meta-analyses","volume":"44","author":"Mari\u00f1o","year":"2022","journal-title":"Rev Bras Ginecol Obstet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"A1","DOI":"10.1016\/j.ygyno.2024.03.012","article-title":"Sentinel lymph node biopsy in high-risk endometrial cancer: the d\u00e9nouement","volume":"182","author":"Glaser","year":"2024","journal-title":"Gynecol Oncol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"CD013021","DOI":"10.1002\/14651858.CD013021.pub2","article-title":"Sentinel node biopsy for diagnosis of lymph node involvement in endometrial cancer","volume":"6","author":"Nagar","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"6462","DOI":"10.3390\/jcm11216462","article-title":"Applications and safety of sentinel lymph node biopsy in endometrial Cancer","volume":"11","author":"Chiu","year":"2022","journal-title":"J Clin Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"367.e1","DOI":"10.1016\/j.ajog.2021.05.034","article-title":"Sentinel lymph node biopsy in high-grade endometrial cancer: a systematic review and meta-analysis of performance characteristics","volume":"225","author":"Marchocki","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"701758","DOI":"10.3389\/fonc.2021.701758","article-title":"Sentinel lymph node mapping in endometrial Cancer: a comprehensive review","volume":"11","author":"Zhai","year":"2021","journal-title":"Front Oncol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1002\/jso.27550","article-title":"Sentinel lymph node mapping in endometrial cancer: current evidence and practice","volume":"129","author":"Salman","year":"2024","journal-title":"J Surg Oncol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"102483","DOI":"10.1016\/j.bpobgyn.2024.102483","article-title":"Sentinel lymph node detection in endometrial cancer - anatomical and scientific facts","volume":"94","author":"Kimmig","year":"2024","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"207","DOI":"10.5114\/pm.2022.119862","article-title":"Sentinel lymph node mapping in endometrial cancer to reduce surgical morbidity: always, sometimes, or never","volume":"21","author":"Daniilidis","year":"2022","journal-title":"Prz Menopauzalny"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"3716","DOI":"10.3390\/ijerph19063716","article-title":"Sentinel lymph node biopsy in surgical staging for high-risk groups of endometrial carcinoma patients","volume":"19","author":"Raffone","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1097\/CCO.0000000000001060","article-title":"Implementation of sentinel node biopsy in high-risk endometrial cancer","volume":"36","author":"Occhiali","year":"2024","journal-title":"Curr Opin Oncol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"102402","DOI":"10.1016\/j.bpobgyn.2023.102402","article-title":"Robotic Para-aortic sentinel lymph node mapping in endometrial, cervical, and ovarian cancer","volume":"90","author":"Van Trappen","year":"2023","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"389","DOI":"10.3390\/cancers15020389","article-title":"Sentinel lymph node biopsy in uterine Cancer: time for a modern approach","volume":"15","author":"Laas","year":"2023","journal-title":"Cancers (Basel)"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.remnie.2022.09.012","article-title":"Controversy over sentinel lymph node detection in endometrial cancer","volume":"41","author":"Paredes","year":"2022","journal-title":"Rev Esp Med Nucl Imagen Mol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.ygyno.2022.05.008","article-title":"Sentinel lymph node mapping for endometrial cancer: opportunity for medical waste reform","volume":"166","author":"Marsh","year":"2022","journal-title":"Gynecol Oncol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"3094","DOI":"10.3390\/jcm10143094","article-title":"Update on sentinel lymph node biopsy in surgical staging of endometrial carcinoma","volume":"10","author":"Eriksson","year":"2021","journal-title":"J Clin Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1007\/s11864-022-00999-5","article-title":"The role of sentinel lymph node mapping in high-grade endometrial Cancer","volume":"23","author":"Yu","year":"2022","journal-title":"Curr Treat Options in Oncol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"321","DOI":"10.5603\/GP.a2021.0214","article-title":"Sentinel lymph node mapping in endometrial cancer after 2020 ESGO-ESTRO-ESP consensus update: what will happen in the next few years?","volume":"93","author":"Barczynski","year":"2022","journal-title":"Ginekol Pol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"70","DOI":"10.23736\/S0026-4806.20.07117-7","article-title":"Sentinel lymph node for endometrial cancer treatment: review of the literature","volume":"112","author":"Zorzato","year":"2021","journal-title":"Minerva Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1016\/j.ajog.2022.02.013","article-title":"Sentinel lymph node biopsy in high-grade endometrial cancer","volume":"226","author":"Marchocki","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.ejogrb.2020.12.038","article-title":"Relevance of sentinel lymph node biopsy in early endometrial cancer: a series of 249 cases","volume":"258","author":"Jayot","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"157","DOI":"10.48095\/cccg2023157","article-title":"Sentinel lymph node mapping in endometrial cancer - robotic vs. laparoscopic detection system","volume":"88","author":"Michal","year":"2023","journal-title":"Cesk Gynekol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1136\/ijgc-2023-004474","article-title":"Sentinel lymph node sampling versus full lymphadenectomy in endometrial cancer: a SEER database analysis","volume":"33","author":"Nahshon","year":"2023","journal-title":"Int J Gynecol Cancer"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1774295\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T07:03:35Z","timestamp":1770793415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1774295\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":27,"alternative-id":["10.3389\/fmed.2026.1774295"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1774295","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]},"article-number":"1774295"}}