Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis
Background: A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting sentinel lymph node performance are heterogeneous...
| Autores: | , , , , , , , |
|---|---|
| Formato: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2023 |
| País: | España |
| Recursos: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/221611 |
| Acesso em linha: | https://hdl.handle.net/2445/221611 |
| Access Level: | acceso abierto |
| Palavra-chave: | Metàstasi Metaanàlisi Ganglis sentinelles Ressenyes sistemàtiques (Investigació mèdica) Càncer d'ovari Metastasis Meta-analysis Sentinel lymph nodes Systematic reviews (Medical research) Ovarian cancer |
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Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysisAgustí, NúriaViveros Carreño, DavidGrillo Ardila, CarlosIzquierdo, NoraParedes Barranco, PilarVidal i Sicart, SergiTorné Bladé, AureliDíaz Feijoo, BertaMetàstasiMetaanàlisiGanglis sentinellesRessenyes sistemàtiques (Investigació mèdica)Càncer d'ovariMetastasisMeta-analysisSentinel lymph nodesSystematic reviews (Medical research)Ovarian cancerBackground: A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting sentinel lymph node performance are heterogeneous and limited. Objective: This study aimed to evaluate the detection rate and diagnostic accuracy of sentinel lymph node mapping in patients with early-stage ovarian cancer. Methods: A systematic search was conducted in Medline (through PubMed), Embase, Scopus, and the Cochrane Library. We included patients with clinical stage I-II ovarian cancer undergoing a sentinel lymph node biopsy and a pelvic and para-aortic lymphadenectomy as a reference standard. We conducted a meta-analysis for the detection rates and measures of diagnostic accuracy and assessed the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with identifying number CRD42022351497. Results: After duplicate removal, we identified 540 studies, 18 were assessed for eligibility, and nine studies including 113 patients were analyzed. The pooled detection rates were 93.3% per patient (95% CI 77.8% to 100%; I2=74.3%, p<0.0001), and the sentinel lymph node technique correctly identified 11 of 12 patients with lymph node metastases, with a negative predictive value per patient of 100% (95% CI 97.6% to 100%; I2=0%). The combination of indocyanine green and 99mTc-albumin nanocolloid had the best detection rate (100% (95% CI 94% to 100%; I2=0%)) when injected into the utero-ovarian and infundibulo-pelvic ligaments. Conclusion: Sentinel lymph node biopsy in early-stage ovarian cancer showed a high detection rate and negative predictive value. The utero-ovarian and infundibulo-pelvic injection using the indocyanine green and technetium-99 combination could increase sentinel lymph node detection rates. However, given the limited quality of evidence and the small number of reports, results from ongoing trials are awaited before its implementation in routine clinical practice.Lippincott, Williams & Wilkins. Wolters Kluwer Health2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/221611Articles publicats en revistes (Fonaments Clínics)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1136/ijgc-2023-004572International Journal of Gynecological Cancer, 2023, vol. 33, num.10, p. 1493-1501https://doi.org/10.1136/ijgc-2023-004572(c) International Gynecologic Cancer Society, 2023info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2216112026-05-27T06:46:51Z |
| dc.title.none.fl_str_mv |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| title |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| spellingShingle |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis Agustí, Núria Metàstasi Metaanàlisi Ganglis sentinelles Ressenyes sistemàtiques (Investigació mèdica) Càncer d'ovari Metastasis Meta-analysis Sentinel lymph nodes Systematic reviews (Medical research) Ovarian cancer |
| title_short |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| title_full |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| title_fullStr |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| title_full_unstemmed |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| title_sort |
Sentinel lymph node detection in early-stage ovarian cancer: a systematic review and meta-analysis |
| dc.creator.none.fl_str_mv |
Agustí, Núria Viveros Carreño, David Grillo Ardila, Carlos Izquierdo, Nora Paredes Barranco, Pilar Vidal i Sicart, Sergi Torné Bladé, Aureli Díaz Feijoo, Berta |
| author |
Agustí, Núria |
| author_facet |
Agustí, Núria Viveros Carreño, David Grillo Ardila, Carlos Izquierdo, Nora Paredes Barranco, Pilar Vidal i Sicart, Sergi Torné Bladé, Aureli Díaz Feijoo, Berta |
| author_role |
author |
| author2 |
Viveros Carreño, David Grillo Ardila, Carlos Izquierdo, Nora Paredes Barranco, Pilar Vidal i Sicart, Sergi Torné Bladé, Aureli Díaz Feijoo, Berta |
| author2_role |
author author author author author author author |
| dc.subject.none.fl_str_mv |
Metàstasi Metaanàlisi Ganglis sentinelles Ressenyes sistemàtiques (Investigació mèdica) Càncer d'ovari Metastasis Meta-analysis Sentinel lymph nodes Systematic reviews (Medical research) Ovarian cancer |
| topic |
Metàstasi Metaanàlisi Ganglis sentinelles Ressenyes sistemàtiques (Investigació mèdica) Càncer d'ovari Metastasis Meta-analysis Sentinel lymph nodes Systematic reviews (Medical research) Ovarian cancer |
| description |
Background: A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting sentinel lymph node performance are heterogeneous and limited. Objective: This study aimed to evaluate the detection rate and diagnostic accuracy of sentinel lymph node mapping in patients with early-stage ovarian cancer. Methods: A systematic search was conducted in Medline (through PubMed), Embase, Scopus, and the Cochrane Library. We included patients with clinical stage I-II ovarian cancer undergoing a sentinel lymph node biopsy and a pelvic and para-aortic lymphadenectomy as a reference standard. We conducted a meta-analysis for the detection rates and measures of diagnostic accuracy and assessed the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with identifying number CRD42022351497. Results: After duplicate removal, we identified 540 studies, 18 were assessed for eligibility, and nine studies including 113 patients were analyzed. The pooled detection rates were 93.3% per patient (95% CI 77.8% to 100%; I2=74.3%, p<0.0001), and the sentinel lymph node technique correctly identified 11 of 12 patients with lymph node metastases, with a negative predictive value per patient of 100% (95% CI 97.6% to 100%; I2=0%). The combination of indocyanine green and 99mTc-albumin nanocolloid had the best detection rate (100% (95% CI 94% to 100%; I2=0%)) when injected into the utero-ovarian and infundibulo-pelvic ligaments. Conclusion: Sentinel lymph node biopsy in early-stage ovarian cancer showed a high detection rate and negative predictive value. The utero-ovarian and infundibulo-pelvic injection using the indocyanine green and technetium-99 combination could increase sentinel lymph node detection rates. However, given the limited quality of evidence and the small number of reports, results from ongoing trials are awaited before its implementation in routine clinical practice. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion |
| format |
article |
| status_str |
acceptedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/2445/221611 |
| url |
https://hdl.handle.net/2445/221611 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Versió postprint del document publicat a: https://doi.org/10.1136/ijgc-2023-004572 International Journal of Gynecological Cancer, 2023, vol. 33, num.10, p. 1493-1501 https://doi.org/10.1136/ijgc-2023-004572 |
| dc.rights.none.fl_str_mv |
(c) International Gynecologic Cancer Society, 2023 info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
(c) International Gynecologic Cancer Society, 2023 |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
application/pdf |
| dc.publisher.none.fl_str_mv |
Lippincott, Williams & Wilkins. Wolters Kluwer Health |
| publisher.none.fl_str_mv |
Lippincott, Williams & Wilkins. Wolters Kluwer Health |
| dc.source.none.fl_str_mv |
Articles publicats en revistes (Fonaments Clínics) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona |
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Universidad de Barcelona |
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Dipòsit Digital de la UB |
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Dipòsit Digital de la UB |
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15.812429 |