Sentinel node mapping in the prostate cancer

 

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Summary

Aim: Sentinel node (SN) biopsy is becoming a standard procedure in the management of several malignancies. Several groups have evaluated the feasibility and value of this procedure in prostate cancer patients. In the current meta-analysis, we comprehensively and quantitatively summarized the results of these studies. Methods: Several databases including Medline, SCOPUS, Google Scholar, Ovid, Springer, and Science direct were systematically searched for the relevant studies regarding SL biopsy in the prostate cancer (“prostate” AND “sentinel” as search keywords). The outcomes of interest were sensitivity and detection rate of the procedure. Results: For detection rate and sensitivity 21 and 16 studies met the criteria of inclusion respectively. Pooled detection rate was 93.8% (95% CI 89–96.6%). Cochrane Q value was 216.077 (I² = 89.81% and p < 0.001). Pooled sensitivity was 94% (95% CI 91–96%). Cochrane Q value was 14.12 (I² = 0.0 and p = 0.516). Conclusion: SL biopsy can prevent unnecessary pelvic lymph node dissection in prostate cancer patients. This procedure is feasible with low false negative rate and high detection rate.

Zusammenfassung

Ziel: Die Wächterlymphknoten(SN)-Biopsie ist ein Standardverfahren in der Abklärung maligner Tumore. Verschiedene Gruppen haben Machbarkeit und Nutzen dieses Verfahrens bei Patienten mit Prostatakarzinom untersucht. In der vorliegenden Metaanalyse wurden die Studienergebnisse zusammengefasst. Methoden: Datenbanken, darunter Medline, SCOPUS, Google Scholar, Ovid, Springer und Science direct wurden systematisch nach relevanten Studien zu SN-Biopsien bei Prostatakarzinom durchsucht („Prostata“ UND „Sentinel“ als Suchbegriffe). Sensitivität und Detektionsrate dieses Verfahrens waren die Zielparameter. Ergebnisse: Bzgl. Detektionsrate und Sensitivität erfüllten 21 bzw. 16 Studien die Einschlusskriterien. Die gepoolte Detektionsrate lag bei 93,8% (95%-KI 89–96,6%), der Q-Wert nach Cochrane bei 216,077 (I² = 89,81% und p < 0,001). Die gepoolte Sensitivität betrug 94% (95%-KI 91–96%); der Q-Wert nach Cochrane lag bei 14,12 (I² = 0,0 und p = 0,516). Schlussfolgerung: Mit der Wächterlymphknoten-Biopsie können unnötige pelvine Lymphadenektomien bei Patienten mit Prostatakarzinom vermieden werden. Wegen einer niedrigen Rate an falsch negativen Ergebnissen und einer hohen Detektionsrate ist dieses Verfahren gut einsetzbar.

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