Objectives: This study aimed to evaluate the introduction of sentinel lymph node biopsy (SLNB) in early-stage endometrial cancer (EC), its learning curve, and factors influencing discrepancies between surgeons and pathologists. Methods: A single-centre retrospective observational study was conducted from June 2019 to December 2024 at the Department of Obstetrics and Gynecology, University Hospital Brno and Faculty of Medicine, Masaryk University. Patients with EC with complete preoperative staging and planned for extrafascial hysterectomy with bilateral salpingo-oophorectomy and SLNB were included. Bilateral detection rates were compared among two main surgeons—one senior fellow (A) and one junior fellow (B)—and other supervised fellows. Learning curves were assessed using detection rates and cumulative sum analysis. Risk factors for failed detection were analysed. Results: In 337 patients, overall bilateral detection rates ranged from 80–92%. Surgeon A achieved 80% success by the 30th procedure and 89% at the 74th. Surgeon B, trained under A’s supervision, reached 89% but later showed a decline after operating independently. The highest concordance with pathologists was noted for Surgeon A (94.6%), followed by B (92.2%) and others (84.9%). Discrepancies were mainly associated with the presence of fibroids (p= 0.005) and adenomyosis (p= 0.018). Conclusions: SNB in EC demonstrates an optimal learning curve that can be shortened through expert guidance. Extending supervised training to 30–35 procedures reduces post-independence decline and sustains high detection rates. Bilateral success, reflecting surgeon–pathologist concordance, is a strong indicator of the quality of a Gynecologic Oncology centre.
目的：本研究旨在评估前哨淋巴结活检（SLNB）在早期子宫内膜癌（EC）中的应用、其学习曲线以及影响外科医生与病理学家结果差异的因素。方法：于2019年6月至2024年12月在布尔诺大学医院妇产科及马萨里克大学医学院开展了一项单中心回顾性观察研究。纳入对象为已完成术前分期并计划接受筋膜外子宫切除术、双侧输卵管卵巢切除术及SLNB的EC患者。比较了两位主要外科医生——一位高级研究员（A）和一位初级研究员（B）——以及其他受指导研究员的双侧检出率。通过检出率及累积和分析评估学习曲线，并分析了检测失败的风险因素。结果：在337例患者中，总体双侧检出率为80%至92%。外科医生A在第30例手术时达到80%的成功率，第74例时达到89%。在外科医生A指导下接受培训的外科医生B虽达到89%的成功率，但在独立操作后出现下降。与病理学家结果一致性最高的是外科医生A（94.6%），其次是B（92.2%）和其他医生（84.9%）。结果差异主要与子宫肌瘤（p=0.005）和子宫腺肌症（p=0.018）的存在相关。结论：EC中的SLNB显示出理想的学习曲线，且可通过专家指导缩短学习时间。将指导培训延长至30–35例手术可减少独立操作后的技能下降，并维持较高的检出率。双侧检测成功率反映了外科医生与病理学家的一致性，是衡量妇科肿瘤中心质量的重要指标。
肿瘤(癌症)患者之家