Sentinel lymph node detection in early stage uterine cervix carcinoma: A systematic review

Jonas van de Lande, Bas Torrenga, Pieter G.H.M. Raijmakers, Otto S. Hoekstra, Marchien W. van Baal, Hans A.M. Brölmann, René H.M. Verheijen

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Objective.: The aim of this study was to systematically review the diagnostic performance of Sentinel Node (SN) detection for assessing the nodal status in early stage cervical carcinoma, and to determine which technique (using blue dye, Technetium-99m colloid (99mTc), or the combined method) had the highest success rate in terms of detection rate and sensitivity. Methods.: A comprehensive computer literature search of English language studies in human subjects on Sentinel Node procedures was performed in MEDLINE and EMBASE databases up to July 2006. For each article two reviewers independently performed a methodological qualitative analysis and data extraction using a standard form. Pooled values of the SN detection rate and pooled sensitivity values of the SN procedure are presented with a 95% confidence interval (95% CI) for the three different SN detection techniques. Results.: We identified 98 articles, and 23 met the inclusion criteria, comprising a total of 842 patients. Ultimately, 12 studies used the combined technique with a sensitivity of 92% (95% CI: 84-98%). Five studies used 99mTc-colloid, with a pooled sensitivity of 92% (95% CI: 79-98%; p = 0.71 vs. combined technique), and four used blue dye with a pooled sensitivity of 81% (67-92%, p = 0.17 vs. combined technique). The SN detection rate was highest for the combined technique: 97% (95% CI: 95-98%), vs. 84% for blue dye (95% CI: 79-89%; p < 0.0001), and 88% (95% CI: 82-92%, p = 0.0018) for 99mTc colloid. Conclusion.: SN biopsy has the highest SN detection rate when 99mTc is used in combination with blue dye (97%), and a sensitivity of 92%. Hence, according to the present evidence in literature the combination of 99mTc and a blue dye for SN biopsy in patients with early stage cervical cancer is a reliable method to detect lymph node metastases in early stage cervical cancer.

Original languageEnglish
Pages (from-to)604-613
Number of pages10
JournalGynecologic Oncology
Volume106
Issue number3
DOIs
Publication statusPublished - 1 Sep 2007

Cite this

van de Lande, Jonas ; Torrenga, Bas ; Raijmakers, Pieter G.H.M. ; Hoekstra, Otto S. ; van Baal, Marchien W. ; Brölmann, Hans A.M. ; Verheijen, René H.M. / Sentinel lymph node detection in early stage uterine cervix carcinoma : A systematic review. In: Gynecologic Oncology. 2007 ; Vol. 106, No. 3. pp. 604-613.
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title = "Sentinel lymph node detection in early stage uterine cervix carcinoma: A systematic review",
abstract = "Objective.: The aim of this study was to systematically review the diagnostic performance of Sentinel Node (SN) detection for assessing the nodal status in early stage cervical carcinoma, and to determine which technique (using blue dye, Technetium-99m colloid (99mTc), or the combined method) had the highest success rate in terms of detection rate and sensitivity. Methods.: A comprehensive computer literature search of English language studies in human subjects on Sentinel Node procedures was performed in MEDLINE and EMBASE databases up to July 2006. For each article two reviewers independently performed a methodological qualitative analysis and data extraction using a standard form. Pooled values of the SN detection rate and pooled sensitivity values of the SN procedure are presented with a 95{\%} confidence interval (95{\%} CI) for the three different SN detection techniques. Results.: We identified 98 articles, and 23 met the inclusion criteria, comprising a total of 842 patients. Ultimately, 12 studies used the combined technique with a sensitivity of 92{\%} (95{\%} CI: 84-98{\%}). Five studies used 99mTc-colloid, with a pooled sensitivity of 92{\%} (95{\%} CI: 79-98{\%}; p = 0.71 vs. combined technique), and four used blue dye with a pooled sensitivity of 81{\%} (67-92{\%}, p = 0.17 vs. combined technique). The SN detection rate was highest for the combined technique: 97{\%} (95{\%} CI: 95-98{\%}), vs. 84{\%} for blue dye (95{\%} CI: 79-89{\%}; p < 0.0001), and 88{\%} (95{\%} CI: 82-92{\%}, p = 0.0018) for 99mTc colloid. Conclusion.: SN biopsy has the highest SN detection rate when 99mTc is used in combination with blue dye (97{\%}), and a sensitivity of 92{\%}. Hence, according to the present evidence in literature the combination of 99mTc and a blue dye for SN biopsy in patients with early stage cervical cancer is a reliable method to detect lymph node metastases in early stage cervical cancer.",
keywords = "Sentinel lymph node, Sentinel node detection rate, Sentinel node sensitivity, Uterine cervix carcinoma, Systematic Review, meta analysis (topic), sentinel lymph node biopsy, Technetium",
author = "{van de Lande}, Jonas and Bas Torrenga and Raijmakers, {Pieter G.H.M.} and Hoekstra, {Otto S.} and {van Baal}, {Marchien W.} and Br{\"o}lmann, {Hans A.M.} and Verheijen, {Ren{\'e} H.M.}",
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Sentinel lymph node detection in early stage uterine cervix carcinoma : A systematic review. / van de Lande, Jonas; Torrenga, Bas; Raijmakers, Pieter G.H.M.; Hoekstra, Otto S.; van Baal, Marchien W.; Brölmann, Hans A.M.; Verheijen, René H.M.

In: Gynecologic Oncology, Vol. 106, No. 3, 01.09.2007, p. 604-613.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Sentinel lymph node detection in early stage uterine cervix carcinoma

T2 - A systematic review

AU - van de Lande, Jonas

AU - Torrenga, Bas

AU - Raijmakers, Pieter G.H.M.

AU - Hoekstra, Otto S.

AU - van Baal, Marchien W.

AU - Brölmann, Hans A.M.

AU - Verheijen, René H.M.

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Objective.: The aim of this study was to systematically review the diagnostic performance of Sentinel Node (SN) detection for assessing the nodal status in early stage cervical carcinoma, and to determine which technique (using blue dye, Technetium-99m colloid (99mTc), or the combined method) had the highest success rate in terms of detection rate and sensitivity. Methods.: A comprehensive computer literature search of English language studies in human subjects on Sentinel Node procedures was performed in MEDLINE and EMBASE databases up to July 2006. For each article two reviewers independently performed a methodological qualitative analysis and data extraction using a standard form. Pooled values of the SN detection rate and pooled sensitivity values of the SN procedure are presented with a 95% confidence interval (95% CI) for the three different SN detection techniques. Results.: We identified 98 articles, and 23 met the inclusion criteria, comprising a total of 842 patients. Ultimately, 12 studies used the combined technique with a sensitivity of 92% (95% CI: 84-98%). Five studies used 99mTc-colloid, with a pooled sensitivity of 92% (95% CI: 79-98%; p = 0.71 vs. combined technique), and four used blue dye with a pooled sensitivity of 81% (67-92%, p = 0.17 vs. combined technique). The SN detection rate was highest for the combined technique: 97% (95% CI: 95-98%), vs. 84% for blue dye (95% CI: 79-89%; p < 0.0001), and 88% (95% CI: 82-92%, p = 0.0018) for 99mTc colloid. Conclusion.: SN biopsy has the highest SN detection rate when 99mTc is used in combination with blue dye (97%), and a sensitivity of 92%. Hence, according to the present evidence in literature the combination of 99mTc and a blue dye for SN biopsy in patients with early stage cervical cancer is a reliable method to detect lymph node metastases in early stage cervical cancer.

AB - Objective.: The aim of this study was to systematically review the diagnostic performance of Sentinel Node (SN) detection for assessing the nodal status in early stage cervical carcinoma, and to determine which technique (using blue dye, Technetium-99m colloid (99mTc), or the combined method) had the highest success rate in terms of detection rate and sensitivity. Methods.: A comprehensive computer literature search of English language studies in human subjects on Sentinel Node procedures was performed in MEDLINE and EMBASE databases up to July 2006. For each article two reviewers independently performed a methodological qualitative analysis and data extraction using a standard form. Pooled values of the SN detection rate and pooled sensitivity values of the SN procedure are presented with a 95% confidence interval (95% CI) for the three different SN detection techniques. Results.: We identified 98 articles, and 23 met the inclusion criteria, comprising a total of 842 patients. Ultimately, 12 studies used the combined technique with a sensitivity of 92% (95% CI: 84-98%). Five studies used 99mTc-colloid, with a pooled sensitivity of 92% (95% CI: 79-98%; p = 0.71 vs. combined technique), and four used blue dye with a pooled sensitivity of 81% (67-92%, p = 0.17 vs. combined technique). The SN detection rate was highest for the combined technique: 97% (95% CI: 95-98%), vs. 84% for blue dye (95% CI: 79-89%; p < 0.0001), and 88% (95% CI: 82-92%, p = 0.0018) for 99mTc colloid. Conclusion.: SN biopsy has the highest SN detection rate when 99mTc is used in combination with blue dye (97%), and a sensitivity of 92%. Hence, according to the present evidence in literature the combination of 99mTc and a blue dye for SN biopsy in patients with early stage cervical cancer is a reliable method to detect lymph node metastases in early stage cervical cancer.

KW - Sentinel lymph node

KW - Sentinel node detection rate

KW - Sentinel node sensitivity

KW - Uterine cervix carcinoma

KW - Systematic Review

KW - meta analysis (topic)

KW - sentinel lymph node biopsy

KW - Technetium

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U2 - 10.1016/j.ygyno.2007.05.010

DO - 10.1016/j.ygyno.2007.05.010

M3 - Review article

VL - 106

SP - 604

EP - 613

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -