M Ansari1, M A Ghodsi Rad2, M Hassanzadeh3, H Gholami4, Z Yousefi3, V R Dabbagh2, R Sadeghi2. 1. Nuclear Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 3. Women's Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Meta-analysis Sub-Committee, Evidence Based Medicine Committee, Mashhad University of Medical Sciences, Masshad, Iran.
Abstract
PURPOSE: Sentinel lymph node biopsy is a fairly new approach for staging of gynecological malignancies. In the current study, the authors comprehensively reviewed the available reports on sentinel node biopsy of endometrial cancer. MATERIALS AND METHODS: The authors searched Medline, SCOPUS, ISI web of knowledge, Science Direct, Springer, OVID SP, and Google Scholar with the following search terms: "endometrium OR endometrial OR uterine OR uterus AND sentinel". The outcomes of interest were detection rate and sensitivity. RESULTS: Overall, 35 studies had enough information for false negative rate evaluation and 51 studies (including the sub-groups of individual studies) for detection rate evaluation (2,071 patients overall). Pooled detection rate was 77.8% (95% CI: 73.5-81.5%) and pooled sensitivity was 89% (95% CI: 83-93%). Cervical injection, as well as using both blue dye and radiotracer, results in higher detection rate and sensitivity. New techniques such as fluorescent dye injection and robotic-assisted surgery showed high detection rate and sensitivity. CONCLUSION: Sentinel node mapping is feasible in endometrial cancer. Using both blue dye and radiotracer and cervical injection of the mapping material can optimize the sensitivity and detection rate of this technique. Larger studies are still needed to evaluate the false negative rate and the factors influencing the sensitivity before considering this method safe.
PURPOSE: Sentinel lymph node biopsy is a fairly new approach for staging of gynecological malignancies. In the current study, the authors comprehensively reviewed the available reports on sentinel node biopsy of endometrial cancer. MATERIALS AND METHODS: The authors searched Medline, SCOPUS, ISI web of knowledge, Science Direct, Springer, OVID SP, and Google Scholar with the following search terms: "endometrium OR endometrial OR uterine OR uterus AND sentinel". The outcomes of interest were detection rate and sensitivity. RESULTS: Overall, 35 studies had enough information for false negative rate evaluation and 51 studies (including the sub-groups of individual studies) for detection rate evaluation (2,071 patients overall). Pooled detection rate was 77.8% (95% CI: 73.5-81.5%) and pooled sensitivity was 89% (95% CI: 83-93%). Cervical injection, as well as using both blue dye and radiotracer, results in higher detection rate and sensitivity. New techniques such as fluorescent dye injection and robotic-assisted surgery showed high detection rate and sensitivity. CONCLUSION: Sentinel node mapping is feasible in endometrial cancer. Using both blue dye and radiotracer and cervical injection of the mapping material can optimize the sensitivity and detection rate of this technique. Larger studies are still needed to evaluate the false negative rate and the factors influencing the sensitivity before considering this method safe.
Authors: Antonio Raffone; Antonio Travaglino; Angela Santoro; Italia Esposito; Giuseppe Angelico; Saveria Spadola; Gian Franco Zannoni Journal: Pathol Oncol Res Date: 2019-08-23 Impact factor: 3.201