Sentinel Lymph Node Mapping in High-risk Endometrial Cancer: a Systematic Review and Meta-analysis

Overview

Journal Gland Surg

Publisher AME Publishing Company

Specialty Endocrinology

Date 2021 Jan 15

PMID 33447560

Citations 8

Authors

Qiang Ji

Xiuying Wang

Jiyong Jiang

Liyan Chen

Affiliations

Soon will be listed here.

Abstract

Background: In the staging of endometrial cancer (EC), the role of sentinel lymph node (SLN) mapping for high-risk EC is still unclear.

Methods: Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. English studies published in PubMed, Embase, and Cochrane Library before 20th SEP, 2019 were retrieved to perform a systematic evaluation and meta-analysis which evaluate the detection rate and diagnostic accuracy of SLN mapping in high-risk EC. Statistical analysis was conducted using stata14.0 software.

Results: A total of 12 studies were included, including 758 high-risk EC patients. The detection rate of SLN mapping was 84.8% (95% CI, 79.9-89.6%). The pooled bilateral detection rate was 67.0% (95% CI, 56.8-77.3%). The pooled para-aortic detection rate was 8.4% (95% CI, 1.8-14.9%). The pooled sensitivity was 87% (95% CI, 79-92%), and the pooled specificity was 98% (95% CI, 96-99%). Pooled negative predictive value (NPV) was 97.7% (95% CI, 96.4-99.1%), AUC =0.99 (95% CI, 0.97-0.099).

Conclusions: SLN mapping still has a high detection rate and diagnostic accuracy in high-risk EC. SLN mapping is a reliable alternative to systematic lymph node dissection, but its prognostic effect on high-risk EC is yet to be further studied and verified by large sample studies.

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References

Wang T, Hu Y, He Y, Sun P, Guo Z . A retrospective validation study of sentinel lymph node mapping for high-risk endometrial cancer. Arch Gynecol Obstet. 2019; 299(5):1429-1435. PMC: 6475504. DOI: 10.1007/s00404-019-05085-0. View

Rajanbabu A, Agarwal R . A prospective evaluation of the sentinel node mapping algorithm in endometrial cancer and correlation of its performance against endometrial cancer risk subtypes. Eur J Obstet Gynecol Reprod Biol. 2018; 224:77-80. DOI: 10.1016/j.ejogrb.2018.03.017. View

Darai E, Dubernard G, Bats A, Heitz D, Mathevet P, Marret H . Sentinel node biopsy for the management of early stage endometrial cancer: long-term results of the SENTI-ENDO study. Gynecol Oncol. 2014; 136(1):54-9. DOI: 10.1016/j.ygyno.2014.09.011. View

Kumar S, Podratz K, Bakkum-Gamez J, Dowdy S, Weaver A, McGree M . Prospective assessment of the prevalence of pelvic, paraaortic and high paraaortic lymph node metastasis in endometrial cancer. Gynecol Oncol. 2013; 132(1):38-43. PMC: 4381544. DOI: 10.1016/j.ygyno.2013.10.002. View

Barlin J, Khoury-Collado F, Kim C, Leitao Jr M, Chi D, Sonoda Y . The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: beyond removal of blue nodes. Gynecol Oncol. 2012; 125(3):531-5. DOI: 10.1016/j.ygyno.2012.02.021. View

Togami S, Kawamura T, Fukuda M, Yanazume S, Kamio M, Kobayashi H . Prospective study of sentinel lymph node mapping for endometrial cancer. Int J Gynaecol Obstet. 2018; 143(3):313-318. DOI: 10.1002/ijgo.12651. View

Zahl Eriksson A, Ducie J, Ali N, McGree M, Weaver A, Bogani G . Comparison of a sentinel lymph node and a selective lymphadenectomy algorithm in patients with endometrioid endometrial carcinoma and limited myometrial invasion. Gynecol Oncol. 2016; 140(3):394-9. PMC: 4839486. DOI: 10.1016/j.ygyno.2015.12.028. View

MIKUTA J . International Federation of Gynecology and Obstetrics staging of endometrial cancer 1988. Cancer. 1993; 71(4 Suppl):1460-3. DOI: 10.1002/cncr.2820710409. View

Ye L, Li S, Lu W, He Q, Li Y, Li B . A Prospective Study of Sentinel Lymph Node Mapping for Endometrial Cancer: Is It Effective in High-Risk Subtypes?. Oncologist. 2019; 24(12):e1381-e1387. PMC: 6975967. DOI: 10.1634/theoncologist.2019-0113. View

10.

Cabanas R . An approach for the treatment of penile carcinoma. Cancer. 1977; 39(2):456-66. DOI: 10.1002/1097-0142(197702)39:2<456::aid-cncr2820390214>3.0.co;2-i. View

11.

Raimond E, Ballester M, Hudry D, Bendifallah S, Darai E, Graesslin O . Impact of sentinel lymph node biopsy on the therapeutic management of early-stage endometrial cancer: Results of a retrospective multicenter study. Gynecol Oncol. 2014; 133(3):506-11. DOI: 10.1016/j.ygyno.2014.03.019. View

12.

How J, Gauthier C, Abitbol J, Lau S, Salvador S, Gotlieb R . Impact of sentinel lymph node mapping on recurrence patterns in endometrial cancer. Gynecol Oncol. 2017; 144(3):503-509. DOI: 10.1016/j.ygyno.2017.01.013. View

13.

Kitchener H, Swart A, Qian Q, Amos C, Parmar M . Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2008; 373(9658):125-36. PMC: 2646126. DOI: 10.1016/S0140-6736(08)61766-3. View

14.

Naoura I, Canlorbe G, Bendifallah S, Ballester M, Darai E . Relevance of sentinel lymph node procedure for patients with high-risk endometrial cancer. Gynecol Oncol. 2014; 136(1):60-4. DOI: 10.1016/j.ygyno.2014.10.027. View

15.

Ianieri M, Puppo A, Novelli A, Campolo F, Staniscia T, Di Martino G . Sentinel Lymph Node Biopsy in the Treatment of Endometrial Cancer: Why We Fail? Results of a Prospective Multicenter Study on the Factors Associated with Failure of Node Mapping with Indocyanine Green. Gynecol Obstet Invest. 2019; 84(4):383-389. DOI: 10.1159/000496699. View

16.

Bogani G, Ditto A, Chiappa V, Raspagliesi F . Sentinel node mapping in endometrial cancer. Transl Cancer Res. 2022; 8(6):2218-2219. PMC: 8797872. DOI: 10.21037/tcr.2019.04.23. View

17.

Ehrisman J, Secord A, Berchuck A, Lee P, Di Santo N, Lopez-Acevedo M . Performance of sentinel lymph node biopsy in high-risk endometrial cancer. Gynecol Oncol Rep. 2016; 17:69-71. PMC: 4941561. DOI: 10.1016/j.gore.2016.04.002. View

18.

Baiocchi G, Mantoan H, Kumagai L, Tirapelli Goncalves B, Badiglian-Filho L, Narciso de Oliveira Menezes A . The Impact of Sentinel Node-Mapping in Staging High-Risk Endometrial Cancer. Ann Surg Oncol. 2017; 24(13):3981-3987. DOI: 10.1245/s10434-017-6132-8. View

19.

Soliman P, Westin S, Dioun S, Sun C, Euscher E, Munsell M . A prospective validation study of sentinel lymph node mapping for high-risk endometrial cancer. Gynecol Oncol. 2017; 146(2):234-239. PMC: 5860676. DOI: 10.1016/j.ygyno.2017.05.016. View

20.

Ignatov A, Lebius C, Ignatov T, Ivros S, Knueppel R, Papathemelis T . Lymph node micrometastases and outcome of endometrial cancer. Gynecol Oncol. 2019; 154(3):475-479. DOI: 10.1016/j.ygyno.2019.07.018. View