title: What is the accuracy of sentinel lymph node biopsy for gastric cancer? A systematic review.
abstract: BACKGROUND
  In gastric cancer, the utility of sentinel lymph node (SLN) biopsy has not been established. SLN may be a good predictor of the pathological status of other lymph nodes and thus the necessity for more extensive surgery or lymph node dissection. We aimed to identify and synthesize findings on the performance of SLN biopsies in gastric cancer.
  
  
  METHODS
  Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from 1998 to 2009. Titles and abstracts were independently rated for relevance by a minimum of two reviewers. Techniques, detection rates, accuracy, sensitivity, specificity, and false-negative rates (FNRs) were analyzed. Analysis was performed based on the FNR.
  
  
  RESULTS
  Twenty-six articles met our inclusion criteria. SLN detection using the dye method (DM) was reviewed in 18 studies, the radiocolloid method (RM) was used in 12 studies, and both dye and radiocolloid methods (DUAL) were used in 5 studies. The DM had an overall calculated FNR of 34.7% (95% confidence interval [CI] 21.2, 48.1). The RM had an overall calculated FNR of 18.5% (95% CI 9.1, 28.0). DUAL had an overall calculated FNR of 13.1% (95% CI -0.9, 27.2).
  
  
  CONCLUSIONS
  Application of the SLN technique may be practical for early gastric cancer. The use of DUAL for identifying SLN may yield a lower FNR than either method alone, although statistical significance was not met.
authors.affiliation: Division of Surgical Oncology, Sunnybrook Research Institute, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Suite T2-60, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
authors.forename: Roberta
authors.initials: R
authors.lastname: Cardoso
authors.forename: Alina
authors.initials: A
authors.lastname: Bocicariu
authors.forename: Matthew
authors.initials: M
authors.lastname: Dixon
authors.forename: Lavanya
authors.initials: L
authors.lastname: Yohanathan
authors.forename: Rajini
authors.initials: R
authors.lastname: Seevaratnam
authors.forename: Lucy
authors.initials: L
authors.lastname: Helyer
authors.forename: Calvin
authors.initials: C
authors.lastname: Law
authors.forename: Natalie G
authors.initials: NG
authors.lastname: Coburn
mesh_terms: D004396:Coloring Agents; D005188:False Negative Reactions; D006801:Humans; D008207:Lymphatic Metastasis; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013274:Stomach Neoplasms / Q000473:pathology*
chemical_list: D004396:Coloring Agents; D019275:Radiopharmaceuticals