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RecruitingLast updated: 23 October 2025

ENDO-3: This trial is testing whether a targeted lymph-node removal approach for early-stage endometrial (uterine) cancer is as safe and effective as not removing them, and whether it helps people recover faster.A Phase III Randomised Clinical Trial Comparing Sentinel Node Biopsy With No Retroperitoneal Node Dissection in Apparent Early-Stage Endometrial Cancer

Trial purpose

Medical clipboardCancer treatment

Tumor type

Female Reproductive System Cancers Gynaecological

Age

People18+

Trial acronym

ENDO-3

Clinical summary

Summary

Endometrial cancer (EC) is the most common cancer affecting the female reproductive system. Treatment usually involves surgery to remove the uterus and to determine the extent of the disease (removal of fallopian tubes, ovaries and if required nearby lymph nodes) - called surgical staging.

Removing lymph nodes (called lymph node dissection) can help guide decisions about further treatment, like chemotherapy and radiation therapy. However, it can also lead to side effects such as swelling in the legs (lymphoedema). A newer technique called sentinel node biopsy (SNB) targets only the first lymph node(s) likely to be affected by cancer. This may reduce side effects, but it's not yet clear how SNB compares to not removing any lymph nodes at all.

About this study

This study aims to find out how helpful SNB is for patients and the healthcare system, and to make sure it doesn't cause harm.

Eligible participants will be randomly assigned to one of two treatment groups:

  • Experimental Group: Surgery will include removal of the uterus, fallopian tubes, and ovaries (called TH-BSO), plus a sentinel node biopsy. A dye is injected near the tumour to help locate the first lymph node(s) that may be affected. These nodes are then removed and tested.
  • Active Comparator Group: Surgery will include removal of the uterus, fallopian tubes, and ovaries (TH-BSO), without removing any lymph nodes.

In both groups, if participants are 45 years or younger, have Grade 1 endometrial adenocarcinoma (EAC) with myometrial invasion <50% and they wish to keep their ovaries, the ovary removal part of the procedure (BSO) may be skipped.

 

Conditions

This trial is treating people with apparent early-stage endometrial cancer

Eligibility

Inclusion

  1. Females, over 18 years, with histologically confirmed primary epithelial cancer of the endometrium of any cell type or uterine carcinosarcoma (mixed malignant mullerian tumour);
  2. Clinically stage I disease (disease confined to body of uterus);
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
  4. Signed written informed consent;
  5. Participant must meet criteria for a laparoscopic or robotic surgical approach as determined by the treating physician (e.g. suitable for TH BSO, ability to tolerate Trendelenberg positioning)
  6. All available clinical evidence (physical examination findings, or medical imaging such as CT, MRI or ultrasound) demonstrates no evidence of extrauterine disease
  7. Myometrial Invasion on MRI of not more than 50%. (Only if participant is <45yo, has ONLY Grade 1 EAC and wishes to retain their ovaries).
  8. Negative (serum or urine) pregnancy test ≤ 30 days of surgery in pre-menopausal women and women < 2 years after the onset of menopause.

Exclusion

  1. Evidence of extrauterine disease (apparent involvement of cervix, vagina, parametria, adnexa, lymph nodes, bladder, bowel or distant sites) by clinical examination and/or through medical imaging.
  2. Enlarged retroperitoneal pelvic and/or aortic lymph nodes (>1 cm) on medical imaging;
  3. Estimated life expectancy of less than 6 months;
  4. Patients who have absolute contraindications for adjuvant radiotherapy and/or chemotherapy;
  5. Patients who have previously received radiation treatment to the pelvis
  6. Serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator);
  7. Patient compliance and geographic proximity that do not allow adequate follow-up;
  8. Patients with allergy to Indocyanine Green (ICG)
  9. Patients who have had previous retroperitoneal surgery
  10. Patients who require a retroperitoneal (pelvic +/- para-aortic) lymph node dissection (lymphadenectomy)
  11. Other prior malignancies <5 years before inclusion, except for successfully treated keratinocyte skin cancers, or ductal carcinoma of the breast insitu
  12. Uterine perforation during endometrial tissue sampling

Inclusion

  • Your cancer has not spread to other parts of the body (localised).

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

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More information

Trial Identifiers

Information on this page is partially produced from ClinicalTrials.gov *. View further details about this trial on the registry via the links below:

Trial sponsor

Queensland Centre for Gynaecological Cancer

Scientific Title

A Phase III Randomised Clinical Trial Comparing Sentinel Node Biopsy With No Retroperitoneal Node Dissection in Apparent Early-Stage Endometrial Cancer

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