High risk group
LND is recommended in high-risk EC according to ESMO-ESGO-ESTRO 2016(25) (Table 3). In the high-risk group, the prevalence of LN involvement is ~19.3%(13). In these patients, worse prognosis can be assumed without LND, with a need for adjuvant treatment guided by node-positive disease(13). Furthermore, without surgical staging including LND, treatment relies on increased use of external beam radiation therapy (EBRT) which is associated with a much higher morbidity than with LND alone(33). While chemotherapy may improve the prognosis of node-positive patients, this is not applicable to node-negative patients, further demonstrating the importance of pathological LN assessment in making adjuvant treatment decisions(33).