The Assessment of Sentinel Lymph Node Mapping Methods in Endometrial Cancer

Background: /Objectives: Methods: This retrospective cohort study included 119 patients with early-stage EC treated at the Maria Skłodowska-Curie National Research Institute of Oncology between 2016 and 2021. Patients underwent SLNB using technetium-99m (Tc99m), indocyanine green (ICG), Patent Blue, or combinations of these tracers. Detection rates for unilateral and bilateral SLNs and the accuracy of metastasis identification were analyzed. Results: The overall SLN detection rate was 97.5%. Detection rates for individual tracers were 100% for ICG, 100% for Patent Blue, and 96% for Tc99m. Combining tracers achieved detection rates of 96.9% (Tc99m + ICG) and 97.3% (Tc99m + Patent Blue). Bilateral detection was highest with Tc99m + ICG (90.6%) and Patent Blue alone (91%). Metastases were identified in 12% of cases, with combined methods improving metastatic detection. No "empty nodes" were observed with Tc99m, compared to 1.7% with Patent Blue and 0.8% with ICG. Conclusions: While combining Tc99m with dyes did not significantly improve overall detection rates, it enhanced metastasis identification and reduced false-negative results. The findings suggest that combined tracer methods can optimize SLNB accuracy in endometrial cancer. Prospective studies are warranted to validate these results.