{
  "abstract": "Background/Objectives: Endometrial intraepithelial neoplasia (EIN)/atypical endometrial hyperplasia (AEH) carries a substantial risk of concurrent endometrial carcinoma; however, the role of sentinel lymph node (SLN) assessment during hysterectomy remains controversial. We performed an updated systematic review and meta-analysis to quantify concurrent carcinoma and evaluate SLN/nodal outcomes in women with preoperative EIN/AEH. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies reporting concurrent carcinoma and/or SLN/nodal outcomes in women with preoperative EIN/AEH undergoing hysterectomy. Proportions were pooled using a random-effects DerSimonian-Laird model with Freeman-Tukey double-arcsine transformation, with subgroup analyses by histological terminology. Risk of bias was assessed using the QUIPS tool. Results: Nineteen studies, including 13,553 women, were included; 14 studies comprising 1174 women contributed to the pooled nodal-positivity estimate. The pooled rate of concurrent carcinoma was 39.6% (95% CI 34.9-44.3; I² = 86%), with rates of 43.8% in AEH/atypical hyperplasia cohorts and 33.4% in EIN cohorts. Pooled nodal positivity was 3.0% (95% CI 2.1-4.0; I² = 0%) and was predominantly low-volume disease. The pooled bilateral SLN detection rate was 71.6% (95% CI 67.3-75.7), and SLN was not associated with excess surgical complications. SLN findings influenced adjuvant treatment decisions in a minority of patients. Conclusion: Concurrent carcinoma occurs in approximately two in five women with preoperative EIN/AEH, whereas nodal metastasis is uncommon and generally low-volume. SLN mapping appears feasible and may inform adjuvant management in selected patients. However, because this estimate was derived largely from patients already selected for higher-risk features, it does not, by itself, establish that risk-based selection would substantially outperform routine assessment. Taken together with preliminary prospective data, it is more appropriately viewed as hypothesis-generating support for a selective, risk-stratified approach, pending larger prospective validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan.",
    "Department of Obstetrics and Gynecology, Tainan Sin-Lau Hospital, Tainan 701, Taiwan.",
    "Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Pei-Chen Li",
      "orcid": "0000-0001-8845-2471"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Dah-Ching Ding",
      "orcid": "0000-0001-5105-068X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/eg6b5fbdfxdq9.bib",
  "cited_by": 0,
  "doi": "10.3390/diagnostics16193114",
  "fulltext_url": "https://europepmc.org/articles/PMC13664625",
  "id": "eg6b5fbdfxdq9",
  "issns": [
    "2075-4418"
  ],
  "landing_url": "https://europepmc.org/article/MED/42882269",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2729|Endometrial and Cervical Cancer Treatments"
    ]
  ],
  "openalex": "W7214302880",
  "pdf_url": "https://europepmc.org/articles/PMC13664625?pdf=render",
  "pmcid": "PMC13664625",
  "pmid": "42882269",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/eg6b5fbdfxdq9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42882269",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42882269"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Endometrial and Cervical Cancer Treatments",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Sentinel Lymph Node Assessment in Endometrial Intraepithelial Neoplasia/Atypical Endometrial Hyperplasia: An Updated Systematic Review and Meta-Analysis.",
  "title_text": "Sentinel Lymph Node Assessment in Endometrial Intraepithelial Neoplasia/Atypical Endometrial Hyperplasia: An Updated Systematic Review and Meta-Analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/eg6b5fbdfxdq9",
  "venue": "Diagnostics (Basel, Switzerland)",
  "versions": []
}