Sentinel lymph node mapping in endometrial cancer: a systematic review and meta-analysis

Abstract

// Hefeng Lin 1 , Zheyuan Ding 2 , Vishnu Goutham Kota 1 , Xiaoming Zhang 1 and Jianwei Zhou 3 1 School of Medicine, Zhejiang University, Hangzhou 310058, China 2 Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China 3 Department of Gynecology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China Correspondence to: Jianwei Zhou, email: zhou_jianwei@126.com Keywords: endometrial cancer, sentinel lymph node mapping, detection rate, sensitivity, meta-analysis Received: February 17, 2017      Accepted: March 20, 2017      Published: March 29, 2017 ABSTRACT Endometrial cancer is the most frequent tumor in the female reproductive system, while the sentinel lymph node (SLN) mapping for diagnostic efficacy of endometrial cancer is still controversial. This meta-analysis was conducted to evaluate the diagnostic value of SLN in the assessment of lymph nodal involvement in endometrial cancer. Forty-four studies including 2,236 cases were identified. The pooled overall detection rate was 83% (95% CI: 80–86%). The pooled sensitivity was 91% (95% CI: 87–95%). The bilateral pelvic node detection rate was 56% (95% CI: 48–64%). Use of indocyanine green (ICG) increased the overall detection rate to 93% (95% CI: 89–96%) and robotic-assisted surgery also increased the overall detection rate to 86% (95% CI: 79–93%). In summary, our meta-analysis provides strong evidence that sentinel node mapping is an accurate and feasible method that performs well diagnostically for the assessment of lymph nodal involvement in endometrial cancer. Cervical injection, robot-assisted surgery, as well as using ICG, optimized the sensitivity and detection rate of the technique. Sentinel lymph mapping may potentially leading to a greater utilization by gynecologic surgeons in the future.