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.