Cpt sentinel lymph node biopsy10/12/2023 ![]() ![]() ![]() Women who have endometrial cancer (cancer arising from the lining of the womb) may have cancer cells spread to lymph nodes in the pelvis and/or the para‐aortic area (main blood vessel in the upper abdominal cavity) and need additional radiotherapy treatment, with or without chemotherapy, following initial hysterectomy. It should be noted that a false‐positive result cannot occur, as the histological examination of the SLN is unchanged by the results from any additional nodes removed at systematic lymphadenectomy.Ĭan tests to identify the main draining lymph nodes in women with endometrial cancer accurately diagnose if the cancer has spread to the lymph nodes? Meta‐regression analyses found that the sensitivities did not differ between the different tracers used, between studies with a majority of women with FIGO stage 1A versus 1B or above between studies assessing the pelvic lymph node basin alone versus the pelvic and para‐aortic lymph node basin or between studies that used subserosal alone versus subserosal and cervical injection. The sensitivity for of SLNB for the different tracers were: blue dye alone 95.2% (95% CI 77.2% to 99.2% 559 women 11 studies low‐certainty evidence) Technetium‐99m alone 90.5% (95% CI 67.7% to 97.7% 257 women 4 studies low‐certainty evidence) technetium‐99m and blue dye 91.9% (95% CI 74.4% to 97.8% 548 women 12 studies low‐certainty evidence) ICG alone 92.5% (95% CI 81.8% to 97.1% 953 women 9 studies moderate‐certainty evidence) ICG and blue dye 90.5% (95% CI 63.2.% to 98.1% 215 women 2 studies low‐certainty evidence) and ICG and technetium‐99m 100% (95% CI 63% to 100% 32 women 1 study very low‐certainty evidence). The pooled sensitivity of SLNB was 91.8% (95% CI 86.5% to 95.1% total 2237 women, of whom 409 had SLN involvement moderate‐certainty evidence). The rates of positive lymph nodes ranged from 5.2% to 34.4% with a mean of 20.1% (95% CI 17.7% to 22.3%). When considered according to which tracer was used, the SLN detection rate ranged from 77.8% (95% CI 70.0% to 85.6%) for blue dye alone (559 women 11 studies low‐certainty evidence) to 100% for ICG and technetium‐99m (32 women 1 study very low‐certainty evidence). In studies that reported bilateral detection the mean rate was 65.4% (95% CI 57.8% to 73.0%). Overall, the mean SLN detection rate was 86.9% (95% CI 82.9% to 90.8% 2237 women 33 studies moderate‐certainty evidence). Overall, the methodological reporting in most of the studies was poor, which resulted in a very large proportion of 'unclear risk of bias' ratings. We found 11 studies that analysed results for blue dye alone, four studies for technetium‐99m alone, 12 studies that used a combination of blue dye and technetium‐99m, nine studies that used indocyanine green (ICG) and near infra‐red immunofluorescence, and one study that used a combination of ICG and technetium‐99m. After screening 232 studies in full text, we found 73 potentially includable records (for 52 studies), although we were only able to extract 2x2 table data for 33 studies, including 2237 women (46 records) for inclusion in the review, despite writing to trial authors for additional information. The search revealed 6259 unique records after removal of duplicates.
0 Comments
Leave a Reply.AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |