Sentinel Node Navigation Surgery for Endometrial Cancer

To date, the results of the clinical trial of sentinel node navigation surgery (SNNS) for endometrial cancer are not reported, and SNNS should be not yet performed as a clinical practice. SNNS is thought to be performed as a clinical trial in the institutions with enough experiences of SN mapping. Regarding the methods of the tracer injection and tracer detection, the diagnostic accuracy of metastasis, the clinical significance of ITC, or micrometastasis, the oncologic significance of solitary metastasis-positive sentinel lymph node (SN) in para-aortic basin, the usefulness of SN biopsy using surgical robots with fluorescence imaging system for detecting ICG, accumulations of clinical trials, and the data analysis in many facilities are needed so that SNNS comes to be safely performed as a clinical practice. Furthermore, the standardization of the diagnosing method for the pathological search for SN and the establishment of the molecular biologic laboratory procedure are necessary, too. However, we think SNNS will emerge as a promising, elegant solution to the ongoing discussion regarding lymphadenectomy in the initial surgical management of endometrial cancer in order to prevent many patients from receiving oversurgery, in order to properly select patients who need to receive lymphadenectomy, and in order to definitely evaluate the risk of recurrence by using ultra-staging or biological diagnosing method in the near future.