**1. Introduction**

100 Cancer of the Uterine Endometrium – Advances and Controversies

[51] Indispensability of pelvic and paraaortic lymphadenectomy in endometrial cancers. Gynecol Oncol 1997;64:411–7. Yokoyama Y, Maruyama H, Sato S, Saito Y [52] Lymphatic drainage of the uterus: preliminary results of an experimental study

[53] Route of lymphatic spread: a study of 112 consecutive patients with endometrial cancer. Mariani A, Webb MJ, Keeney GL, Podratz KC. Gynecol Oncol 2001;81:100–4. [54] The outcomes of 27,063 women with unstaged endometrioid uterine cancer. Chan JK,

[55] The role of pelvic and/or para-aortic lymphadenectomy in surgical management of

[56] Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm

[57] Laparoscopic paraaortic left-sided transperitoneal infrarenal lymphadenectomy in

[58] Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a

[59] Lymphadenectomy for the management of endometrial cancer (Review) May K, Bryant A, Dickinson HO, Kehoe S, Morrison J The Cochrane Library 2010, Issue 1 [60] F.H. van Wijk, M.E.L. van der Burg, Curt W. Burgeret al. Management of Surgical Stage

[61] Creasman W, Odicino F, Maisonneuve P, et al. Carcinoma of the corpus uteri. Int J

[62] Boruta DM 2nd, Gehrig PA, Groben PA, et al. Uterine serous and grade 3 endometrioid carcinomas: is there a survival difference? Cancer. 2004;101:2214-2221 [63] Goff BA, Goodman A, Muntz HG, et al. Surgical stage IV endometrial carcinoma: a

[64] Chi DS, Welshinger M, Venkatraman ES, et al. The role of surgical cytoreduction in

[65] Bristow RE, Zerbe MJ, Rosenshein NB, et al. Stage IVB endometrial carcinoma: the

role of cytoreductive surgery and determinants of survival. Gynecol Oncol.

Stage IV endometrial carcinoma. Gynecol Oncol. 1997;67:56-60.

Obstet Biol Reprod (Paris) 1997;26:418–23.

YT, Nam JH. Ann Surg Oncol. 2010 Mar;17(3):861-8.

Sakuragi N. Lancet. 2010 Apr 3;375(9721):1165-72.

study of 47 cases. Gynecol Oncol. 1994;52: 237-240.

Wilson TO, Podratz KC. Gynecol Oncol. 2008 Apr;109(1):11-8.

Klemm P, Schneider A. Gynecol Oncol. 2003 Oct;91(1):139-48.

Aug;106(2):282-8.

Cancer 2009;19: 431-446

2000;78:85-91.

Gynaecol Obstet. 2006;95:S105-S143.

[French]. Lécuru F, Neji K, Robin F, Darles C, de Bièvre P, Taurelle R. J Gynecol

Wu H, Cheung MK, Shin JY, Osann K, Kapp DS. Gynecol Oncol. 2007

apparently early carcinosarcoma of uterus. Park JY, Kim DY, Kim JH, Kim YM, Kim

shift in surgical staging. Mariani A, Dowdy SC, Cliby WA, Gostout BS, Jones MB,

patients with gynecologic malignancies: technique and results. Köhler C, Tozzi R,

retrospective cohort analysis. Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M,

III and IV Endometrioid Endometrial Carcinoma. An Overview. Int J Gynecol

The value of lymphadenectomy (LND) in the management of endometrial cancer remains controversial. Although it is required for the surgical staging of the disease (FIGO 2009) and its prognostic value is indisputable, its therapeutic benefit remains a matter of debate. Furthermore, systematic pelvic (PLND) and para-aortic lymphadenectomy (PaLND) cause morbidity, even when performed using minimally invasive surgical techniques. A reliable means of sentinel lymph node (SLN) mapping may be the way forward. In this chapter we review the literature surrounding this topic, identify areas for research and suggest a pragmatic approach to managing this dilemma.
