Sentinel node navigation surgery in cervical cancer: a systematic review and metaanalysis

Tatsuyuki Chiyoda, Kosuke Yoshihara, Masahiro Kagabu, Satoru Nagase, Hidetaka Katabuchi, Mikio Mikami, Tsutomu Tabata, Yasuyuki Hirashima, Yoichi Kobayashi, Masanori Kaneuchi, Hideki Tokunaga, Tsukasa Baba

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)

Abstract

Sentinel node navigation surgery (SNNS) is used in clinical practice for the treatment of cervical cancer. This study aimed to elucidate the appropriate sentinel lymph node (SLN) mapping method and assess the safety and benefits of SNNS. We searched the PubMed, Ichushi, and Cochrane Library databases for randomized controlled trials (RCT) and studies on SLN in cervical cancer from January 2012 to December 2020. Two authors independently assessed study quality and extracted data. We quantitatively analyzed the detection rate, sensitivity/specificity, and complications and reviewed information, including the survival data of SLN biopsy (SLNB) without pelvic lymphadenectomy (PLND). The detection rate of SLN mapping in the unilateral pelvis was median 95.7% and 100% and in the bilateral pelvis was median 80.4% and 90% for technetium-99 m (Tc) with/without blue dye (Tc w/wo BD) and indocyanine green (ICG) alone, respectively. The sensitivity and specificity of each tracer were high; the area under the curve of each tracer was 0.988 (Tc w/wo BD), 0.931 (BD w/wo Tc), 0.966 (ICG), and 0.977 (carbon nanoparticle). Morbidities including lymphedema, neurological symptoms and blood loss were associated with PLND. One RCT and five studies all showed SNNS without systematic PLND does not impair recurrence or survival in early-stage cervical cancer with a tumor size ≤ 2–4 cm. Both Tc w/wo BD and ICG are appropriate SLN tracers. SNNS can reduce the morbidities associated with PLND without affecting disease progression in early-stage cervical cancer.

Original languageEnglish
Pages (from-to)1247-1255
Number of pages9
JournalInternational Journal of Clinical Oncology
Volume27
Issue number8
DOIs
Publication statusPublished - 2022 Aug

Keywords

  • Cervical cancer
  • Meta-analysis
  • Minimally invasive surgery
  • Sentinel lymph node
  • Sentinel node navigation surgery
  • Systematic review

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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