Sentinel lymph node biopsy in cervical cancer: A meta‑analysis

Wu,Yibo; Li,Zeming; Wu,Haiyan; Yu,Jinjin

doi:10.3892/mco.2013.168

Sentinel lymph node biopsy in cervical cancer: A meta‑analysis

Authors:
- Yibo Wu
- Zeming Li
- Haiyan Wu
- Jinjin Yu
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Affiliations: Department of Gynecology and Obstetrics, Wuxi Fourth People's Hospital, Jiangnan University, Wuxi, Jiangsu 214062, P.R. China
Published online on: August 16, 2013 https://doi.org/10.3892/mco.2013.168
Pages: 1025-1030

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Abstract

Sentinel lymph node biopsy (SLNB) is used to determine the pathological status of the first lymph node receiving lymphatic drainage from the primary tumor. The diagnostic value of SLNB for the assessment of the nodal status in patients with cervical cancer has not been determined. Therefore, this meta‑analysis was conducted to assess the diagnostic value of SLNB in cervical cancer. A search for related literature was performed using PubMed. data were analyzed using a random effects model and a subgroup analysis was used to assess the diagnostic value of different practices during the process. A total of 17 studies involving a total of 1,112 patients were included in the analysis. The pooled sentinel lymph node (SLN) detection rate, sensitivity and negative predictive values were 92.2% [95% confidence interval (CI): 88.3‑94.8%], 88.8% (95% CI: 85.1‑91.7%) and 95.0% (95% CI: 92.8‑96.6%), respectively. The subgroup analysis revealed that laparoscopy, tracer combination and immunohistochemistry were associated with a higher SLN detection rate. In conclusion, the SLNB in cervical cancer appears to be of diagnostic value, particularly the procedure with the combination of laparoscopy, combined tracers and immunohistochemistry. However, further studies are required to establish the clinical value of SLNB in cervical cancer.

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1.	Cabanas RM: An approach for the treatment of penile carcinoma. Cancer. 39:456–466. 1977. View Article : Google Scholar : PubMed/NCBI
2.	Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al: Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 127:392–399. 1992. View Article : Google Scholar : PubMed/NCBI
3.	Morrow M, Rademaker AW, Bethke KP, Talamonti MS, Dawes LG, Clauson J and Hansen N: Learning sentinel node biopsy: results of a prospective randomized trial of two techniques. Surgery. 126:714–720. 1999. View Article : Google Scholar : PubMed/NCBI
4.	Lyman GH, Giuliano AE, Somerfield MR, et al: American Society of Clinical Oncology: American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 23:7703–7720. 2005. View Article : Google Scholar : PubMed/NCBI
5.	Malur S, Krause N, Kohler C and Schneider A: Sentinel lymph node detection in patients with cervical cancer. Gynecol Oncol. 80:254–257. 2001. View Article : Google Scholar : PubMed/NCBI
6.	Levenback C, Coleman RL, Burke TW, Lin WM, Erdman W, Deavers M and Delpassand ES: Lymphatic mapping and sentinel node identification in patients with cervix cancer undergoing radical hysterectomy and pelvic lymphadenectomy. J Clin Oncol. 20:688–693. 2002. View Article : Google Scholar : PubMed/NCBI
7.	Achouri A, Huchon C, Bats AS, Bensaid C, Nos C and Lecuru F: Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol. 39:81–86. 2013. View Article : Google Scholar
8.	Ayhan A, Celik H, Dursun P, Gultekin M and Yuce K: Prognostic and therapeutic importance of lymphadenectomy in gynecological cancers. Eur J Gynaecol Oncol. 25:279–286. 2004.PubMed/NCBI
9.	Hauspy J, Beiner M, Harley I, Ehrlich L, Rasty G and Covens A: Sentinel lymph node in vulvar cancer. Cancer. 110:1015–1023. 2007. View Article : Google Scholar : PubMed/NCBI
10.	Kang S, Yoo HJ, Hwang JH, Lim MC, Seo SS and Park SY: Sentinel lymph node biopsy in endometrial cancer: meta-analysis of 26 studies. Gynecol Oncol. 123:522–527. 2011. View Article : Google Scholar : PubMed/NCBI
11.	Selman TJ, Mann C, Zamora J, Appleyard TL and Khan K: Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis. CMAJ. 178:855–862. 2008. View Article : Google Scholar : PubMed/NCBI
12.	Wallace BC, Schmid CH, Lau J and Trikalinos TA: Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data. BMC Med Res Methodol. 9:802009. View Article : Google Scholar : PubMed/NCBI
13.	DerSimonian R and Laird N: Meta-analysis in clinical trials. Control Clin Trials. 7:177–188. 1986. View Article : Google Scholar : PubMed/NCBI
14.	Rhim CC, Park JS, Bae SN and Namkoong SE: Sentinel node biopsy as an indicator for pelvic nodes dissection in early stage cervical cancer. J Korean Med Sci. 17:507–511. 2002. View Article : Google Scholar : PubMed/NCBI
15.	Lambaudie E, Collinet P, Narducci F, Sonoda Y, Papageorgiou T, Carpentier P, Leblanc E and Querleu D: Laparoscopic identification of sentinel lymph nodes in early stage cervical cancer: prospective study using a combination of patent blue dye injection and technetium radiocolloid injection. Gynecol Oncol. 89:84–87. 2003. View Article : Google Scholar
16.	Plante M, Renaud MC, Tetu B, Harel F and Roy M: Laparoscopic sentinel node mapping in early-stage cervical cancer. Gynecol Oncol. 91:494–503. 2003. View Article : Google Scholar : PubMed/NCBI
17.	Niikura H, Okamura C, Akahira J, Takano T, Ito K, Okamura K and Yaegashi N: Sentinel lymph node detection in early cervical cancer with combination ^99mTc phytate and patent blue. Gynecol Oncol. 94:528–552. 2004. View Article : Google Scholar : PubMed/NCBI
18.	Roca I, Caresia AP, Gil-Moreno A, et al: Usefulness of sentinel lymph node detection in early stages of cervical cancer. Eur J Nucl Med Mol Imaging. 32:1210–1216. 2005. View Article : Google Scholar : PubMed/NCBI
19.	Silva LB, Silva-Filho AL, Traiman P, et al: Sentinel node detection in cervical cancer with ^99mTc-phytate. Gynecol Oncol. 97:588–595. 2005. View Article : Google Scholar : PubMed/NCBI
20.	Wydra D, Sawicki S, Wojtylak S, Bandurski T and Emerich J: Sentinel node identification in cervical cancer patients undergoing transperitoneal radical hysterectomy: a study of 100 cases. Int J Gynecol Cancer. 16:649–654. 2006. View Article : Google Scholar
21.	Zhang WJ, Zheng R, Wu LY, Li XG, Li B and Chen SZ: Clinical application of sentinel lymph node detection to early stage cervical cancer. Chin J Cancer. 25:224–228. 2006.(In Chinese).
22.	Schwendinger V, Muller-Holzner E, Zeimet AG and Marth C: Sentinel node detection with the blue dye technique in early cervical cancer. Eur J Gynaecol Oncol. 27:359–362. 2006.PubMed/NCBI
23.	Kara PP, Ayhan A, Caner B, Gultekin M, Ugur O, Bozkurt MF and Usubutun A: Sentinel lymph node detection in early stage cervical cancer: a prospective study comparing preoperative lymphoscintigraphy, intraoperative gamma probe, and blue dye. Ann Nucl Med. 22:487–494. 2008. View Article : Google Scholar
24.	Pazin V, Dragojević S, Miković Z, et al: The value of sentinel lymphadenectomy in radical operative treatment of cervical cancer. Mil Med Pharm Rev. 66:539–543. 2009.PubMed/NCBI
25.	Darlin L, Persson J, Bossmar T, Lindahl B, Kannisto P, Måsbäck A and Borgfeldt C: The sentinel node concept in early cervical cancer performs well in tumors smaller than 2 cm. Gynecol Oncol. 117:266–269. 2010. View Article : Google Scholar : PubMed/NCBI
26.	Ogawa S, Kobayashi H, Amada S, et al: Sentinel node detection with ^99mTc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy. Int J Clin Oncol. 15:52–58. 2010.
27.	Lécuru F, Mathevet P, Querleu D, et al: Bilateral negative sentinel nodes accurately predict absence of lymph node metastasis in early cervical cancer: results of the SENTICOL study. J Clin Oncol. 29:1686–1691. 2011.
28.	Roy M, Bouchard-Fortier G, Popa I, Grégoire J, Renaud MC, Têtu B and Plante M: Value of sentinel node mapping in cancer of the cervix. Gynecol Oncol. 122:269–274. 2011. View Article : Google Scholar : PubMed/NCBI
29.	Van de Lande J, Torrenga B, Raijmakers PG, Hoekstra OS, van Baal MW, Brölmann HA and Verheijen RH: Sentinel lymph node detection in early stage uterine cervix carcinoma: a systematic review. Gynecol Oncol. 106:604–613. 2007.PubMed/NCBI
30.	Van Trappen PO and Pepper MS: Lymphatic dissemination of tumour cells and the formation of micrometastases. Lancet Oncol. 3:44–52. 2002.PubMed/NCBI