644 Sentinel node biopsy in cancer endometrium - real world experience in the low middle income (LMIC) setting

Introduction/Background Endometrial cancer (EC) is one of the most common gynecological malignancies. Sentinel lymph node biopsy (SLNB) has emerged as a minimally invasive technique to accurately assess lymph node status while reducing the morbidity associated with traditional lymphadenectomy. Real world data from LMIC about the outcome and survival pattern after SLNB in cancer endometrium is limited. Ours is a tertiary cancer care centre in LMIC where SLNB for cancer endometrium is being practiced since 2017.In this study we assessed the detection rate, mapping pattern, safety profile of different techniques for SLNB in EC and evaluated the survival outcome after SLNB in high risk endometrial cancer. Methodology This is a retrospective study done in patients who underwent SLNB during surgical staging for early stage EC in our centre from 1st January 2018 to 31stAugust 2023. SLNB using Technetium or blue dye or Indocyanine green(ICG) has been used in this period. Results Data of 160 patients were analysed, 104 had low grade endometrioid histology and 56 had high risk histology. 105 patients underwent SLNB using ICG, 33 using Blue dye and 22 using a combination of Technetium and blue dye. ICG had an overall detection rate of 87.6% and bilateral detection rate of 64%, which was superior when compared to others.. Among Low grade endometrioid histologies, 17.5% LN mets were identified whereas there were 11.9% LN mets among high risk histologies. Median follow up of these patients were 21 months, with a 1.5 year OS- 100% and 1.5 year DFS- 99.1%. Conclusion With a good detection rate, and with a trend towards similar survival, even in high risk histologies, SLNB using SLN algorithm could be a safe alternative to lymphadenectomy in EC. Disclosures None.