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

Zhang, Xinyue; Bao, Bingting; Wang, Sixue; Yi, Mingyu; Jiang, Li

doi:10.1002/cam4.3645

Cited by 22 publications

(23 citation statements)

References 37 publications

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“…The latest detailed data shows that the pooled specific side detection rates were 85% in tumors up to 2 cm, 67% in tumors over 2 cm, 75.2% for blue dye, 74.7% for Tc, 84% for combined technique, and 85.5% for ICG. [ 42 ] These consequences consistent with the results of other authors. Despite caveats in current evidence and discrepancies in available data, there is growing evidence that SLN mapping is feasible and results in an excellent detection rate in patients with cervical cancer.…”

Section: Discussionsupporting

confidence: 92%

Sentinel lymph node mapping in early-stage cervical cancer

Wang

Liu

et al. 2021

Medicine

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Background: The value of sentinel lymph node (SLN) mapping for early-stage cervical cancer remains controversial. Therefore, we collected data to investigate the feasibility and diagnostic accuracy of SLN in patients with early-stage (IA-IIA) cervical cancer. Methods: We searched Embase, PubMed, and the Cochrane Library databases issued before June 1, 2020. The sample size of the selected study was at least 10 patients with early-stage (IA-IIA) cervical cancer, the pooled detection rates and the separate detection rate (overall detection rate, bilateral detection rate) using blue dye with Tc, technetium 99 (Tc) and indocyanine green (ICG) technique of early-stage cervical cancer was reported. R-3.6.1 software was used to evaluate pooled detection rate and sensitivity. Results: Two thousand one hundred sixty-four patients included for analysis in 28 studies ranging from 12 to 405 patients. The combined overall detection rate of SLN mapping was 95% with a 72% pooled bilateral detection rate. The sensitivity of the combined overall detection rate of SLN mapping was 94.99% as well as a sensitivity of 72.43% bilateral detection rate. The overall detection rate of SLN was 96% for blue dye with Tc, 95% for Tc, 98% for ICG technique. The bilateral detection rate of SLN was 76% for blue dye with Tc, 63% for Tc, 85% for ICG technique. The sensitivity of the overall detection rate of SLN mapping was 97.76% as well as a sensitivity of 84.96% bilateral detection rate of ICG technique. Conclusion: In early-stage cervical cancer, overall detection rate of SLN mapping is elevated while bilateral detection rate is lower. The overall detection rate (98%) as well as bilateral rate (85%) of ICG seems to be a better SLN mapping technique among the method of SLN mapping (using blue dye with Tc, Tc or ICG). We believe SLN mapping may be considered contemporary technique which could provide additional benefits over traditional pelvic lymphadenectomy. While promising results in SLN mapping has been found, larger patient samples, including randomized studies, are required at the same time.

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Section: Discussionsupporting

confidence: 92%

Sentinel lymph node mapping in early-stage cervical cancer

Wang

Liu

et al. 2021

Medicine

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“…In cervical cancer, a recent meta-analysis including 21 studies and 2234 patients found lymphatic mapping with 88% side specific sensitivity. Side specific detection rates were similar with technetium-based or indocyanine green-based mapping [ 57 ]. In endometrial cancer, retrospective comparison of SLN biopsy to complete node dissection found fewer complications for SLN patients, particularly in relation to lymphedema [ 58 ].…”

Section: Application Of Sentinel Lymph Node Surgery To Different Type...mentioning

confidence: 77%

The lymphatic system and sentinel lymph nodes: conduit for cancer metastasis

Leong

Pissas

Scarato

et al. 2021

Clin Exp Metastasis

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The lymphatic system is a complicated system consisting of the lymphatic vessels and lymph nodes draining the extracellular fluid containing cellular debris, excess water and toxins to the circulatory system. The lymph nodes serve as a filter, thus, when the lymph fluid returns to the heart, it is completely sterile. In addition, the lymphatic system includes the mucosa-associated lymphoid tissue, such as tonsils, adenoids, Peyers patches in the small bowel and even the appendix. Taking advantage of the drainage system of the lymphatics, cancer cells enter the lymphatic vessels and then the lymph nodes. In general, the lymph nodes may serve as a gateway in the majority of cases in early cancer. Occasionally, the cancer cells may enter the blood vessels. This review article emphasizes the structural integrity of the lymphatic system through which cancer cells may spread. Using melanoma and breast cancer sentinel lymph node model systems, the spread of early cancer through the lymphatic system is progressive in a majority of cases. The lymphatic systems of the internal organs are much more complicated and difficult to study. Knowledge from melanoma and breast cancer spread to the sentinel lymph node may establish the basic principles of cancer metastasis. The goal of this review article is to emphasize the complexity of the lymphatic system. To date, the molecular mechanisms of cancer spread from the cancer microenvironment to the sentinel lymph node and distant sites are still poorly understood and their elucidation should take major priority in cancer metastasis research.

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“…In recent years, there have been many studies on sentinel lymph node [31][32][33], and relevant articles have pointed out that sentinel lymph node mapping has a good detection rate for early-stage cervical cancer tumors [34,35], but in early-stage cervical cancer, overall detection rate of sentinel lymph node mapping is elevated while bilateral detection rate is lower [36].…”

Section: Signi Cancementioning

confidence: 99%

Analysis of Lymph Node Metastasis and Risk Factors in 975 Patients with FIGO 2009 Stage ⅠA-ⅡA Cervical Cancer

Cao

Kong

et al. 2022

Preprint

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Objective To summarize the lymph node metastasis (LNM) rate of patients with stage ⅠA-ⅡA cervical cancer, and further analyze its distribution characteristics and related risk factors. Methods According to FIGO 2009, the clinical data of 975 patients with stage ⅠA-ⅡA cervical cancer treated in our hospital from January 2010 to December 2018 were retrospectively analyzed. The incidence and distribution of LNM were analyzed, and the influencing factors of cervical cancer LNM were analyzed by univariate and multivariate Logistic regression. Results In this study, the LNM rate was 14.8%(144/975), and a total of 20288 lymph nodes were removed, among which 359 lymph nodes had metastasis. According to the statistics of the number and frequency of metastatic lymph nodes in different regions, the metastatic rate was the highest in the parauterine/obturator regions. Univariate analysis showed that pregnancy > 3 times, tumor size > 4cm, gross type, FIGO stage, pathological type, positive lymphovascular space invasion (LVSI), deep cervical stromal invasion (outer 1/2 invasion), parametrial involvement and uterine corpus invasion (UCI) were all correlated with LNM (P <0.05). Multivariate analysis showed tumor lesion >4cm (OR=2.253,95%CI:1.486-3.416,P<0.001), positive LVSI (OR=5.353,95%CI: 3.303-8.676, P <0.001), deep cervical stromal invasion (OR=3.461, 95%CI: 2.106-5.688, P<0.001)and deep UCI (myometrial invasion≥50%) (OR=3.529, 95%CI: 1.321-9.427, P=0.012)were independent risk factors for LNM. Conclusion C ervical cancer patients are more likely to have LNM if the tumor size > 4cm, positive LVSI, deep cervical stromal invasion and deep UCI. In clinical treatment, attention should be paid to the evaluation of LNM.

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

Cited by 22 publications

References 37 publications

Sentinel lymph node mapping in early-stage cervical cancer

Sentinel lymph node mapping in early-stage cervical cancer

The lymphatic system and sentinel lymph nodes: conduit for cancer metastasis

Analysis of Lymph Node Metastasis and Risk Factors in 975 Patients with FIGO 2009 Stage ⅠA-ⅡA Cervical Cancer

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