72 Sentinel lymph node mapping: the answer to the surgical staging dilemma in elderly patients with endometrial cancer

Introduction/Background Nearly half of women diagnosed with endometrial cancer (EC) are 70 years old or older. Furthermore, elderly patients (>65 years) have been at risk for adverse perioperative outcomes throughout various surgical procedures and have a poorer prognosis which is related to both aggressive disease and under-treatment. We aimed to compare surgical and oncological outcomes between elderly (>65 year-old), intermediate to high risk, endometrial cancer patients undergoing staging with sentinel lymph node (SLN) staging and pelvic lymphadenectomy (LND). Methodology A prospective cohort study of elderly patients diagnosed with endometrial carcinoma between 2007 and 2017, treated in a single center in Montreal, comparing surgical and oncological outcomes of 3 endometrial cancer patients cohorts in non-overlapping eras, undergoing surgical staging including: LND, LND+SLN or SLN. 2-year progression-free survival (PFS), overall survival (OS), and disease-specific survival (DSS) were analyzed using life tables, Kaplan-Meier survival curves and log-rank tests. Results Out of 278 patients with a median age of 73 (65–91) years, that were staged and met the study inclusion criteria, 84 patients underwent LND only, 120 underwent SLN followed by LND and 74 patients had only SLN. Patients in the SLN group had significantly less dissected nodes (mean of 5.4 nodes vs 10.4 and 10.0 in the SLN+LND and the LND cohorts, respectively, p Conclusion SLN based surgical staging is feasible, precise, affects adjuvant treatment and associated with better surgical and oncological outcomes in intermediate and high risk elderly patients. Disclosures We have no disclosures.