Sentinel Node Biopsy in Urothelial Carcinoma of the Bladder: Systematic Review and Meta-Analysis
| Autor: | Maliheh Keshvari, Leili Zarifmahmoudi, Mahmoud Tavakkoli, Hamidreza Ghorbani, Maryam Salehi, Ramin Sadeghi, Kayvan Sadri |
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| Rok vydání: | 2018 |
| Předmět: |
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medicine.medical_specialty Carcinoma Transitional Cell Bladder cancer medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Urology 030232 urology & nephrology Cancer Publication bias Sentinel node medicine.disease 03 medical and health sciences 0302 clinical medicine Urinary Bladder Neoplasms 030220 oncology & carcinogenesis Meta-analysis Biopsy medicine Humans Stage (cooking) business |
| Zdroj: | Urologia internationalis. 103(4) |
| ISSN: | 1423-0399 |
| Popis: | Objectives: To determine the application of sentinel node biopsy in urothelial carcinoma of the bladder, we performed a systematic review and meta-analysis. Methods: Pooled false negative rate and detection rate were presented using Meta-Disc (version 1.4), and comprehensive meta-analysis (version 2). Publication bias and heterogeneity were assessed using funnel plot, Cochrane Q test, and I2 index. Results: The pooled detection rate was 91% (95% CI 87–93%) and pooled sensitivity was 79% (95% CI 0.69–0.86%). When the neoadjuvant chemotherapy group of patients was omitted, the pooled sensitivity changed to 82% (95% CI 74–88%), and the Cochrane Q and I2 statistics were 15.44 and 48.2%, respectively. The pooled sensitivity of studies that included > 50% of pT 3 or 4 patients was 70% (59–80), by omitting studies that enrolled > 50% of patients at pT stage of 3 or 4, the pooled sensitivity increased to 93% (81–98). Conclusions: Although the studies on SN biopsy of muscle invasive bladder cancer patients resulted in a high detection rate and sensitivity, further validated multicenter trials with larger sample size are essential to confirm the reliability and accuracy of this approach and obtain a standardized method. We showed that pT1 or pT2 bladder cancer patients with clinically negative lymph nodes are the most appropriated group for sentinel lymph node mapping. |
| Databáze: | OpenAIRE |
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