Persson J, et al. - A pelvic sentinel lymph node (SLN) algorithm was prospectively investigated for its diagnostic accuracy in high-risk endometrial cancer (HREC). Researchers adhered to an anatomically based algorithm after cervical injection of indocyanine green (ICG), with reinjection of tracer in case of non-display of predefined lymphatic pathways. A pelvic and infrarenal para-aortic lymphadenectomy was performed after removal of SLNs. Among 257 consecutive women with presumed FIGO stage I-II HREC who underwent robotic surgery at two academic centers by five accredited surgeons, pelvic lymph node metastases (LNMs) were observed in 54; of these, 52 were correctly identified by the SLN-ICG. Observations suggest that in the hands of experienced surgeons, the described pelvic SLN algorithm can exclude overall nodal involvement in 99% with a complete sensitivity to detect pelvic LNMs, and thereby can safely replace a full lymphadenectomy in HREC. The bilateral pelvic mapping rate increases with reinjection of tracer. They recommend primarily considering lower aortic tracer-positive nodes as echelon nodes. Reduction in true para-aortic skip metastases was noted with ultrasectioning of pelvic sentinel nodes.