Efficacy of SLNB in Early Endometrial Adenocarcinoma in China: A Retrospective Cohort Study Using Propensity Score Matching

Abstract Background Endometrial cancer significantly impacts women’s reproductive health and quality of life, with lymph node metastasis serving as a crucial prognostic factor. Given the low metastasis rate, not all early-stage patients require lymph node dissection. The NCCN upgraded Sentinel Lymph Node Biopsy (SLNB) technology to Class 2A evidence. However, the applicability of SLNB for Chinese patients remains uncertain. This study evaluates the efficacy and safety of SLNB in a Chinese population. Methods We conducted a retrospective cohort study at Guangdong Provincial Hospital of Chinese Medicine, involving 164 patients with early endometrial adenocarcinoma who underwent laparoscopic total hysterectomy with bilateral salpingo-oophorectomy from August 2019 to December 2022. Patients were divided into two groups based on the surgical approach: SLNB (N = 33) or systematic lymph node dissection (SLND, N = 33). The primary outcomes assessed were postoperative disease progression-free survival and complication incidence at one month. Secondary outcomes included surgery duration, blood loss, length of hospital stay, and total costs. Result Throughout the follow-up period, there were no recurrences case reported in either group. The complication rates were 6% for SLNB and 21% for SLND. In comparison to SLND, SLNB significantly reduced surgery duration (156.4 minutes vs. 267.18 minutes; p < 0.001), blood loss (33.90 ml vs. 98.18 ml; p < 0.01), length of hospital stay (13.48 days vs. 16.76 days; p < 0.01), and total costs (RMB47,203.88 vs. RMB57,969.58; p < 0.01). Conclusion SLNB is a less invasive and cost-effective alternative to SLND, offering comparable safety and efficacy for the management of early-stage endometrial cancer in Chinese patients.