New trial toassess sentinel lymph node removal during surgery for early-stage endometrial cancer

University of Queensland researchers have received a $3.1 million grant for a trial which could revolutionize endometrial cancer treatment.

Research Director Professor Andreas Obermair at UQ’s Queensland Centre for Gynaecological Cancer Research said the trial will assess sentinel lymph node removal during surgery for early-stage endometrial cancer.

“The standard treatment is a hysterectomy and lymph node dissection, despite the effectiveness of this second part of the surgery not being proven,” Professor Obermair said.

“Doctors use lymph node dissection to determine the extent of the disease, but there is no evidence of patient benefit.

“In fact, it may put the patient at risk by prolonging the operation and anesthetic time and delay their recovery.

“Patients have also expressed concern that the current surgical approach may cause more harm than good.”

Called ENDO3, the trial will address patient and clinician concerns and fill a 30-year knowledge gap by evaluating the effectiveness, benefit and risks of sentinel lymph node removal.

“Ultimately, we aim to reduce the potential for unnecessary overtreatment of women with endometrial cancer,” Professor Obermair said.

Endometrial cancer is the most common gynecological cancer in Australia, with more than 3,000 patients treated annually.

Professor Obermair said the National Health and Medical Research Council (NHMRC) grant will progress the trial and expand it to international collaboration.

“For 20 years, we have been advocating for greater research funding because we know the treatment options we currently have for women with gynecological cancer are outdated and patients deserve better,” he said.

“ENDO3 already has support from the international gynecological oncology community because it’s recognised the trial results will support better treatment decisions.”

Over 5 years, the ENDO3 team will randomize 760 patients with stage one endometrial cancer to surgery with or without sentinel lymph node dissection.

The trial will determine the probability of disease-free survival at four years.

So far, 158 patients are enrolled with 16 accredited surgeons.