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An appropriate strategy of surgery and adjuvant treatment are controversial because of heterogenous characteristics of stage II EM cancer. According to current National Comprehensive Cancer Network (NCCN) guidelines [1], options for adjuvant therapy of stage II cases are external beam radiation therapy, vaginal brachytherapy, or combination of both. And there has been controversy whether a pelvic and/or para-aortic lymph node (LN) dissection should be recommended. Although no difference of survival benefit in stage I EM cancer between surgery with and without lymphadenectomy [2], combined pelvic and para-paraaortic lymphadenectomy showed significantly better overall survival than pelvic lymphadenectomy in patients with intermediateor high-risk of recurrence group [3]. However, higher risk of leg edema with increasing number of LNs dissected was also reported [4]. In a prospective cohort study of measuring the value of sentinel LN mapping compared to the complete lymphadenectomy in detecting metastatic LN, they showed a high degree of diagnostic accuracy [5]. Therefore, the sentinel node sampling may be a new approach in the evaluation of EM cancer.

Stage II endometrial cancer requires stratification according to uterine risk factor and sentinel lymph node sampling