Application of cervical combined with bilateral uterine cornual injection of tracer in sentinel lymph node mapping of early endometrial cancer.

Currently, sentinel lymph node (SLN) mapping in early-stage endometrial cancer typically involves a single-site cervical injection. While this method reliably identifies SLNs along the cervical drainage pathway, it has limited sensitivity for detecting SLNs that follow the uterine body pathway, particularly paraaortic lymph nodes. In this study, the combined injection of tracer into the cervix and bilateral uterine cornua allows for the identification of sentinel lymph nodes in both the uterine body and cervical drainage pathways. Forty patients with early-stage endometrial cancer participated in a study for SLN mapping of the cervix and uterine body. Initially, 1 mL CNPs was injected into each uterine cornu at a depth of 0.3-1.0 cm to identify and remove paraaortic SLNs. Next, 1 mL CNPs was injected at the 3 and 9 o'clock positions on the cervix to locate pelvic SLNs. Concurrently, we retrospectively collected data on 40 patients treated at our hospital from June 2023 to June 2024 who received a single-site CNP injection in the cervix, serving as a control group. This study has been registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2600120340, Registration Date: March 12,2026). The cervical combined with bilateral uterine cornua SLN localization strategy demonstrates a remarkably high detection rate, with an overall sentinel lymph node detection rate of 97.5% (39/40) and a bilateral pelvic SLN visualization rate of 80% (32/40). The paraaortic SLN detection rate was 87.5% (35/40), while isolated paraaortic SLN detection was 5% (2/40). In the control group, the pelvic SLN detection rate was 95% (38/40), and the bilateral pelvic SLN visualization rate was 90% (36/40). The paraaortic SLN detection rate in the control group was 5% (2/40). Notably, the experimental group showed a significant increase in the successful detection rate of paraaortic sentinel lymph nodes, rising from 5% (2/40) in the control group to 87.5% (35/40), with this difference being statistically significant (P < 0.001). The SLN positioning strategy, which combines the cervix with bilateral uterine cornuas, effectively identifies lymph nodes of the fundus and cervical drainage. This strategy offers a higher visualization rate of paraaortic lymph nodes and can detect isolated paraaortic lymph node metastases compared to the cervical injection method. It is also feasible for evaluating sentinel lymph nodes in endometrial cancer. This study has been registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2600120340, Registration Date: March 12,2026).