Sentinel lymph node mapping in early-stage cervical cancer: Meta-analysis

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Medical Imaging

Background:

• The clinical utility of sentinel lymph node (SLN) mapping in early-stage cervical cancer (IA-IIA) is debated.
• Investigating the feasibility and diagnostic accuracy of SLN mapping is crucial for refining treatment strategies.

Purpose of the Study:

• To evaluate the feasibility and diagnostic accuracy of sentinel lymph node (SLN) mapping in early-stage cervical cancer (IA-IIA).
• To compare the effectiveness of different SLN mapping techniques, including blue dye with Technetium-99 (Tc) and indocyanine green (ICG).

Main Methods:

• Systematic literature search of Embase, PubMed, and Cochrane Library databases (pre-June 1, 2020).
• Inclusion of studies with at least 10 patients diagnosed with early-stage (IA-IIA) cervical cancer.
• Meta-analysis using R 3.6.1 software to assess pooled detection rates and sensitivity of SLN mapping techniques.

Main Results:

• Analysis of 28 studies involving 2,164 patients revealed a combined overall detection rate of 95% for SLN mapping.
• The pooled bilateral detection rate was 72%. Indocyanine green (ICG) demonstrated the highest overall (98%) and bilateral (85%) detection rates.
• Sensitivity for overall detection was 94.99%, with ICG achieving 97.76% overall and 84.96% for bilateral detection.

Conclusions:

• Sentinel lymph node (SLN) mapping is feasible and accurate for early-stage cervical cancer, with high overall detection rates.
• Indocyanine green (ICG) appears to be the most effective SLN mapping technique, offering superior detection rates.
• SLN mapping may offer advantages over traditional pelvic lymphadenectomy, though larger, randomized studies are warranted.