In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Giuseppe Cucinella, Andrea Mariani, and Gretchen E. Glaser to discuss ITCs in low-risk endometrial cancer. Giuseppe Cucinella, MD, is a gynecologist working at Istituto Nazionale Tumori IRCSS Fondazione G.Pascale in Naples, Italy (Department of Gynecologic Oncology). During his residency, he worked as a research fellow at Mayo Clinic in Rochester, Minnesota, where he focused on the study of endometrial cancer. He is currently in the second year of the PhD program in "Experimental Oncology and Surgery - Gynecologic Oncology" at the University of Palermo, Palermo (Italy). Dr. Cucinella's clinical research focuses on the diagnosis and treatment of endometrial cancer and minimally invasive surgery in gynecologic oncology. Dr. Andrea Mariani is a Full Professor in the Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, at Mayo Clinic in Rochester, Minnesota.  Dr. Mariani is the Gynecologic Oncology Division Chair in the Department of Obstetrics and Gynecology.  Dr. Mariani’s research interest is endometrial cancer with a special interest in robotic surgery. He is internationally recognized for his contributions in the advancement of surgical and postoperative treatment of endometrial cancer. Gretchen E. Glaser, MD is a Gynecologic Oncologist at Mayo Clinic specializing in complex surgery for malignant and benign conditions, including minimally invasive and open approaches. In addition to her clinical work, Dr. Glaser focuses her clinical research in endometrial cancer diagnosis, treatment, and outcomes as well as quality improvement of surgical care using enhanced recovery after surgery techniques. She also serves as the Vice Chair and Practice Chair for Obstetrics and Gynecology and has a special interested in patient and physician wellness.

Highlights:

• The aim of our study was to evaluate the prognostic value of SLNs-isolated tumor cells in patients with low-risk endometrial cancer who underwent SLN biopsy and did not receive adjuvant therapy. Outcomes were compared with node negative patients.

• Our study shows that recurrence free survival among patients with low-risk endometrial cancer and no adjuvant treatment was significantly worse in patients with SLNs–isolated tumor cells compared with negative nodes. However, we did not observe any significant difference in overall survival.

• The presence of SLNs-isolated tumor cells, lymphovascular space invasion, and International Federation of Obstetrics and Gynecology (FIGO) grade 2 were significant risk factors for recurrence (any recurrence and non-vaginal recurrence).

• Our group has designed a prospective multicenter cohort study called ENDO-ITC with the aim of definitively establishing the prognostic role of ITC in an otherwise low-risk population who undergo SLN biopsy. In addition, we will evaluate a standardized follow-up plan for these patients.