Sentinel node biopsy in endometrial cancer: systematic review and meta-analysis of the literature.
OBJECTIVE
Sentinel lymph node biopsy is a fairly new approach for staging of gynecological malignancies. In the current study, the authors comprehensively reviewed the available reports on sentinel node biopsy of endometrial cancer.


METHODS
The authors searched Medline, SCOPUS, ISI web of knowledge, Science Direct, Springer, OVID SP, and Google Scholar with the following search terms: "endometrium OR endometrial OR uterine OR uterus AND sentinel". The outcomes of interest were detection rate and sensitivity.


RESULTS
Overall, 35 studies had enough information for false negative rate evaluation and 51 studies (including the sub-groups of individual studies) for detection rate evaluation (2,071 patients overall). Pooled detection rate was 77.8% (95% CI: 73.5-81.5%) and pooled sensitivity was 89% (95% CI: 83-93%). Cervical injection, as well as using both blue dye and radiotracer, results in higher detection rate and sensitivity. New techniques such as fluorescent dye injection and robotic-assisted surgery showed high detection rate and sensitivity.


CONCLUSIONS
Sentinel node mapping is feasible in endometrial cancer. Using both blue dye and radiotracer and cervical injection of the mapping material can optimize the sensitivity and detection rate of this technique. Larger studies are still needed to evaluate the false negative rate and the factors influencing the sensitivity before considering this method safe.
Nuclear Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
M
M
Ansari
Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
M A Ghodsi
MA
Rad
Women's Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
M
M
Hassanzadeh
Meta-analysis Sub-Committee, Evidence Based Medicine Committee, Mashhad University of Medical Sciences, Masshad, Iran.
H
H
Gholami
Women's Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Z
Z
Yousefi
Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
V R
VR
Dabbagh
Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
R
R
Sadeghi
D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017594:Publication Bias; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*