title: Accuracy of sentinel lymph node biopsy for inguinal lymph node staging of penile squamous cell carcinoma: systematic review and meta-analysis of the literature.
abstract: OBJECTIVE
  Sentinel lymph node biopsy is emerging as a promising method for inguinal lymph node staging of penile squamous cell carcinoma. In the current systematic review we evaluated the accuracy of sentinel lymph node biopsy for inguinal lymph node staging of penile squamous cell carcinoma and studied possible influential factors.
  
  
  METHODS
  MEDLINE®, Scopus®, ISI®, Ovid SP®, Springer, ScienceDirect® and Google™ Scholar were searched by the key words "(penile OR penis) AND sentinel". No date or language limitation was imposed on the search and meeting abstracts were not excluded from analysis. A random effects model was used for statistical pooling.
  
  
  RESULTS
  A total of 17 studies suitable for meta-analysis were detected. Three articles had 2 different subgroups of patients and each subgroup was considered as a separate study. Overall 18 studies (including the subgroups) were used for detection rate meta-analysis and 19 for sensitivity meta-analysis. The pooled detection rate was 88.3% (95% CI 81.9-92.6). Pooled detection rate of 90.1% (95% CI 83.6-94.1) was calculated for the studies using blue dye and radiotracer. The pooled sensitivity was 88% (95% CI 83-92). The highest pooled sensitivity (92% [95% CI 86-96]) was in the studies using radiotracer and blue dye, and recruiting only cN0 cases.
  
  
  CONCLUSIONS
  Sentinel lymph node mapping in penile squamous cell carcinoma is a method with a high detection rate and sensitivity. Using radiotracer and blue dye for sentinel lymph node mapping and including only cN0 disease ensures the highest detection rate and sensitivity.
authors.affiliation: Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. sadeghir@mums.ac.ir
authors.forename: Ramin
authors.initials: R
authors.lastname: Sadeghi
authors.forename: Hassan
authors.initials: H
authors.lastname: Gholami
authors.forename: Seyed Rasoul
authors.initials: SR
authors.lastname: Zakavi
authors.forename: Vahid Reza Dabbagh
authors.initials: VR
authors.lastname: Kakhki
authors.forename: Kamyar Tavakkoli
authors.initials: KT
authors.lastname: Tabasi
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary*; D006801:Humans; D007264:Inguinal Canal; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy