Efﬁcacy of vaginal natural oriﬁce transluminal endoscopic sentinel lymph node biopsy for endometrial cancer: a prospective multicenter cohort study

Q: What is the purpose of this prospective multicenter study?

To verify that vaginal NOTES (vNOTES) can be performed safely and effectively for early endometrial cancer staging surgery.

Q: How were participants allocated to vNOTES or laparoscopic staging?

vNOTES or multiport laparoscopic staging was selected according to each patient’s wishes among 120 stage I endometrial cancer patients.

Q: What were the key outcomes comparing vNOTES with conventional laparoscopy?

vNOTES showed sentinel lymph node detection rates that were noninferior at a −15% cutoff, with significantly lower pain scores at 12 h and 24 h and a shorter median postoperative hospital stay; no intraoperative complications occurred in either group.

Sep 24, 2026

Uploaded by supergirl

Prospective multicenter cohort study evaluates whether vaginal natural orifice transluminal endoscopic surgery (vNOTES) can be performed safely and effectively for early endometrial cancer staging. Conducted in two tertiary hospitals in southern China from January 2021 to May 2022, it enrolled 120 stage I patients comparing vNOTES with multiport laparoscopic staging. Primary endpoint was sentinel lymph node detection rate; secondary endpoints included perioperative outcomes, pain scores, and hospital stay. vNOTES achieved noninferior detection rates with significantly lower postoperative pain and shorter stay, while no intraoperative complications were observed; long-term survival requires further study.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Materials and Methods

Results

Conclusion

Keywords

Highlights

’Prospective Cohort Study Efﬁcacy of vaginal natural oriﬁce transluminalendoscopic sentinel lymph node biopsy for endometrial cancer: a prospective multicenter cohort study Li Deng, MDa , Yi Liu, MDb , Yuanyan Yao, MDa , Yuan Deng, MDa , Shuai Tang, MDa , Li Sun, MDb,c,* , Yanzhou Wang, MDa,* Introduction: Natural oriﬁce transluminal endoscopic surgery (NOTES) is performed increasingly often despite the lack of highquality evidence conﬁrming its safety, especially for malignant diseases. The aim of this prospective study is to verify that vaginal NOTES (vNOTES) can be performed safely and effectively in early endometrial cancer staging surgery. Materials and Methods: This prospective study was conducted in two tertiary hospitals in southern China from January 2021 to May 2022 . A total of 120 patients with stage I endometrial cancer were included. vNOTES or multiport laparoscopic staging surgery was selected according to each patient’s wishes. The primary outcome was the sentinel lymph node detection rate, analyzed by anoninferiority test. The secondary outcomes were perioperative outcomes. Results: Among the 120 patients enrolled, 57 underwent vNOTES, and 63 underwent multiport laparoscopy. The patient-speciﬁc detection rates of sentinel lymph nodes were 94.73 and 96.82% in the vNOTES and laparoscopy groups, respectively. Additionally, the bilateral detection rates were 82 .46 and 84 . 13%, and the side-speciﬁc detection rates were 88 .60 and 90 .48% in these two groups, respectively. All three detection rates in the vNOTES group were noninferior to those of laparoscopy group at a noninferiority cutoff of –15% . The median operation times of the vNOTES and laparoscopy groups were 132 .35 and 138 .73 min (P = 0.362), and the median estimated blood loss were 75 and 50 ml (P = 0.096), respectively. No intraoperative complications occurred in either group. The pain scores on the Numerical Rating Scale at both 12 h and 24 h after operation were signiﬁcantly lower in the vNOTES group (P < 0.001) and the median postoperative hospital stay was signiﬁcantly shorter in the vNOTES group (P = 0.001) . Conclusion: This study illustrates the potential applicability of vNOTES in gynecological malignancy surgery by demonstrating its safety and effectiveness in endometrial cancer staging. However, its long-term survival outcomes require further exploration. Keywords: comprehensive surgical staging, endometrial cancer, sentinel lymph nodes, vNOTES Introduction Staging surgery is an important strategy for the treatment of early endometrial cancer. The National Comprehensive Cancer Network and European Society of Radiology and Oncology both recommend minimally invasive surgery as the preferred surgical approach for early endometrial cancer staging, including multiport laparoscopy, single-site laparoscopy, and robot-assisted laparoscopy, which have been studied extensively[1–3] . Gynecologists have also HIGHLIGHTS • Pelvic and abdominal sentinel lymph nodes can be detected accurately by vaginal NOTES (vNOTES) . • vNOTES gets similar perioperative outcomes with conventional laparoscopy. • vNOTES for malignancy represents an expanded scope of the developed technology. aDepartment of Obstetricsand Gynecology, The First Afﬁliated Hospital (Southwest Hospital), Army Medical University, Chongqing, bDepartments of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital l & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen and cDepartments of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article *Corresponding authors. Address: Departments of Gynecological Oncology, National Cancer

FAQs

What is the purpose of this prospective multicenter study?

To verify that vaginal NOTES (vNOTES) can be performed safely and effectively for early endometrial cancer staging surgery.

How were participants allocated to vNOTES or laparoscopic staging?

vNOTES or multiport laparoscopic staging was selected according to each patient’s wishes among 120 stage I endometrial cancer patients.

What were the key outcomes comparing vNOTES with conventional laparoscopy?

vNOTES showed sentinel lymph node detection rates that were noninferior at a −15% cutoff, with significantly lower pain scores at 12 h and 24 h and a shorter median postoperative hospital stay; no intraoperative complications occurred in either group.

Sep 24, 2026

Uploaded by supergirl