Impact of Sentinel Lymph Node Biopsy Versus Complete Lymphadenectomy on Quality of Life and Lymphedema in Early-Stage Endometrial Cancer: A Prospective Cohort Study

Purpose This study aimed to compare health-related quality of life (HRQoL), overall health perception (oHP), and the incidence of lower-limb lymphedema in early-stage endometrial cancer patients undergoing either sentinel lymph node (SLN) biopsy or complete pelvic lymphadenectomy (CL). Methods In this prospective, single-center study, 97 patients diagnosed with early-stage endometrial cancer underwent either SLN biopsy alone (n=47) or SLN mapping followed by CL (n=50). HRQoL and oHP were assessed using the EQ-5D-3L and a 0–100 visual analogue scale at baseline and six months postoperatively. Lymphedema was evaluated using the Self-report Lower-Extremity Lymphedema Questionnaire (LELQ). Results Patients in the SLN group reported significantly higher oHP (median 85 vs. 70; p =0.001) and better HRQoL scores (median 5 vs. 7; p =0.001) compared to the CL group. Symptomatic lymphedema was more frequent in the CL group (34.4% vs. 7.0%; p =0.002). No significant differences were observed in intraoperative or postoperative complications between the groups. Conclusion SLN biopsy was associated with improved patient-reported outcomes and a lower incidence of lymphedema, with similar surgical safety compared to complete lymphadenectomy. These findings support SLN biopsy as a preferred nodal staging technique in early-stage endometrial cancer.