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Review
. 2022 Mar 21;19(6):3716.
doi: 10.3390/ijerph19063716.

Sentinel Lymph Node Biopsy in Surgical Staging for High-Risk Groups of Endometrial Carcinoma Patients

Antonio Raffone  1   2 , Diego Raimondo  2 , Antonio Travaglino  3 , Giulia Rovero  2 , Manuela Maletta  2 , Ivano Raimondo  4 , Marco Petrillo  4 , Giampiero Capobianco  4 , Paolo Casadio  2 , Renato Seracchioli  2 , Antonio Mollo  5
Affiliations
Review

Sentinel Lymph Node Biopsy in Surgical Staging for High-Risk Groups of Endometrial Carcinoma Patients

Antonio Raffone et al. Int J Environ Res Public Health. .

Abstract

Background: In endometrial carcinoma (EC) patients, sentinel lymph node (SLN) biopsy has shown the potential to reduce post-operative morbidity and long-term complications, and to improve the detection of low-volume metastasis through ultrastaging. However, while it has shown high sensitivity and feasibility in low-risk EC patient groups, its role in high-risk groups is still unclear.

Aim: To assess the role of SLN biopsy through the cervical injection of indocyanine green (ICG) in high-risk groups of early-stage EC patients.

Materials and methods: Seven electronic databases were searched from their inception to February 2021 for studies that allowed data extraction about detection rate and accuracy of SLN biopsy through the cervical injection of ICG in high-risk groups of early-stage EC patients. We calculated pooled sensitivity, false negative (FN) rate, detection rate of SLN per hemipelvis (DRh), detection rate of SLN per patients (DRp), and bilateral detection rate of SLN (DRb), with 95% confidence interval (CI).

Results: Five observational cohort studies (three prospective and two retrospective) assessing 578 high risk EC patients were included. SLN biopsy sensitivity in detecting EC metastasis was 0.90 (95% CI: 0.03-0.95). FN rate was 2.8% (95% CI: 0.6-11.6%). DRh was 88.4% (95% CI: 86-90.5%), DRp was 96.6% (95% CI: 94.7-97.8%), and DRb was 80% (95% CI: 75.4-83.9).

Conclusion: SLN biopsy through ICG cervical injection may be routinely adopted instead of systematic pelvic and para-aortic lymphadenectomy in surgical staging for high-risk groups of early-stage EC patients, as well as in low-risk groups.

Keywords: endometrium; lymph node dissection; lymphadenectomy; mapping; risk assessment; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Forest plots of individual studies and pooled sensitivity of sentinel lymph node biopsy in detecting endometrial carcinoma metastasis.
Figure 2
Figure 2
Forest plots of individual studies and pooled false negative rate of sentinel lymph node biopsy in detecting endometrial carcinoma metastasis.
Figure 3
Figure 3
Forest plots of individual studies and pooled detection rate of sentinel lymph node per hemipelvis.
Figure 4
Figure 4
Forest plots of individual studies and pooled detection rate of sentinel lymph node per patient.
Figure 5
Figure 5
Forest plots of individual studies and pooled bilateral detection rate of sentinel lymph node.
See this image and copyright information in PMC

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