Recent national trends in pelvic and paraaortic lymphadenectomy in gynecologic oncology fellowship training programs: ACGME data from 2019-2025

<h4>Purpose</h4>To investigate trends in surgical experience performing pelvic and paraaortic lymphadenectomies by gynecologic oncology (GO) fellows in the U.S.<h4>Methods</h4>Summary statistics for ACGME GO training programs were obtained from the ACGME public reporting system. The ACGME data only contains this short time frame. For each academic year spanning 2019-2020 through 2024-2025, the national mean procedure count was extracted for pelvic and paraaortic lymphadenectomies.<h4>Results</h4>Over the past 5 years there has been a significant decline in the number of pelvic (p = 0.0004) and paraaortic (p = 0.002) lymphadenectomies being performed by GO fellows in the U.S. During this same time there was a progressive significant upward trend in the number of SNL performed (p = 0.003). The mean procedure count declined from 61 to 38 on pelvic and 36 to 18 on <i>para</i>-aortic and SLN increased from 63 to 96.<h4>Conclusions</h4>Gynecologic oncology training experience in performing both pelvic and paraaortic lymphadenectomy has declined. The decline may have implications that extend to training in radical pelvic surgery.