Kennard JA, et al. - In this study involving patients seemingly with uterine-confined endometrial cancer, researchers studied sentinel lymph node (SLN) pathology and the links to uterine pathology, non-sentinel pelvic lymph nodes, and para-aortic lymph nodes. The participants had robotic hysterectomy, SLN mapping, completion pelvic lymphadenectomy (LND), and para-aortic (PaLND) directed by frozen section. Based on histology, the 414 patients were risk stratified. Compared to low-risk (LR)/intermediate-risk patients, more micro/macro-metastases in both SLNs and non-SLN metastases were detected among patients with high-risk (HR) histology. A clinically significant incidence of PaLN metastasis across all histology risk groups was noted in relation to SLN isolated tumor cells. They found no cases of isolated aortic node metastasis. In the HR cohort vs LR patients, an increased, although clinically acceptable false negative rate of SLN mapping was evident.