Limitations
Our study has several limitations. Since the clinical impact of SLN
mapping for high-risk endometrial histologies, such as UPSC, CC and MMMT
are not as robustly studied, it is difficult to assess the significance
of the three documented false negative SLN in patients with UPSC
histology in our cohort. It has previously been shown that elimination
of lymphadenectomy in cases of high-risk histology may be associated
with more risk of treatment failure [10]. Given the relatively small
sample size, the data in our study is insufficient to comment on safety
or feasibility of SLNB in high-risk endometrial histologic subtypes and
our practice is to perform a complete lymphadenectomy after SLN mapping
for these cases. Additionally, although we did not discover associations
between SLN mapping rates and BMI, presence of leiomyoma, adenomyosis
and depth of invasion, it is possible that associations would be seen in
a larger cohort. Overall, the power of this study is limited by the
sample size of patients and the retrospective nature of our study
design. There were no recurrences in our patients, but long-term follow
up will provide additional information with regards to disease
recurrence.