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Meta-Analysis
. 2014:2014:489536.
doi: 10.1155/2014/489536. Epub 2014 May 26.

Prognostic significance of sentinel lymph node mapping in Merkel cell carcinoma: systematic review and meta-analysis of prognostic studies

Ramin Sadeghi  1 , Zohreh Adinehpoor  1 , Masoud Maleki  2 , Babak Fallahi  3 , Luca Giovanella  4 , Giorgio Treglia  4
Affiliations
Meta-Analysis

Prognostic significance of sentinel lymph node mapping in Merkel cell carcinoma: systematic review and meta-analysis of prognostic studies

Ramin Sadeghi et al. Biomed Res Int. 2014.

Abstract

Aim: To assess through a systematic review and meta-analysis of the literature the prognostic implication of sentinel lymph node mapping in Merkel cell carcinoma (MCC).

Materials and methods: PubMed and SCOPUS databases were searched by using "Merkel AND sentinel" as keywords. All studies with prognostic information regarding SLN mapping in cN0 MCC patients were included. Hazard ratio (HR) for overall survival (OS) and disease free survival (DFS) was used as effect size.

Results: SLN biopsy predicted better DFS and OS as compared to the nodal observation in cN0 MCC patients (pooled HR for DFS: 1.61 (95% CI: 1.05-2.46), P = 0.028; pooled HR for OS: 1.08 (95% CI: 0.55-2.10), P = 0.8). Pathologically negative SLN (SLN-) patients had better OS (pooled HR: 4.42 (95% CI: 1.82-10.7), P = 0.0009) and DFS (pooled HR: 2.58 (95% CI: 1.78-3.73)) as compared to SLN+ patients.

Conclusion: SLN mapping can provide strong prognostic information regarding OS and DFS in cN0 MCC patients. More importantly, SLN mapping can improve DFS and possibly OS in cN0 MCC patients as compared to nodal observation. As MCC is a rare tumor, large multicenter prospective studies are still needed to validate the survival benefit of SLN mapping.

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Figures

Figure 1
Figure 1
PRISMA flowchart of the study.
Figure 2
Figure 2
Forest plot of the hazard ratio (HR) of disease free survival (DFS) and overall survival (OS) for operative staging with SLN mapping versus nodal observation.
Figure 3
Figure 3
Forest plot of the hazard ratio (HR) of disease free survival (DFS) and overall survival (OS) for pathological SLN status.
Figure 4
Figure 4
Funnel plots of meta-analyses of pathological SLN status for DFS and OS.
See this image and copyright information in PMC

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