2022-RA-781-ESGO MLH1 promoter hypermethylation in mismatch repair deficient endometrial cancer. Defining a new subgroup?

Abstract

was 65.5 years (56-82), ASA score=2 and mean BMI=31.8. Women underwent total hysterectomy and bilateral salpingooophorectomy in all, adhesiolysis (48%), omental sampling (20%) and para-aortic sampling (16%). The FIGO stages included stage-I (88%) and Stage-III (12%). Median lymph node count in SLN was 3 (1-5) and BPLND was 15 (5-38). Nodal metastasis was 8%. Para-aortic lymph node positivity was 4%. SLND sensitivity was 100%, specificity 96.15%, false-negative rate 0%, negative predictive value 100%. Median time for SLND was 15 min (10-22) while BPLND was 35 min (25-40). Bilateral SLND was achieved in 96%. Obturator node was the most common SLN site (40%). 8% SLN were detected in paraaortic and parametrial sites. Complication rate was 1.8%. Conclusion Our pilot study shows that SLND with ICG in intermediate and high-risk endometrial cancer is accurate with high negative predictive values. The quality of nodal assessment was improved by identifying aberrant location in 8% women with SLND. Our series is comparable to international standards and mandates a change in institutional practice. SLND-only is accurate technique for nodal assessment in surgical staging for intermediate and high-risk endometrial cancers.