Accuracy of sentinel node biopsy in esophageal carcinoma: a systematic review and meta-analysis of the pertinent literature
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The use of sentinel node surgery for esophageal carcinoma is still under investigation. We evaluated the data available in the literature on this topic, and herein present the results in a systematic review format. PUBMED, SCOPUS, the ISI web of knowledge and the information from the annual meetings of the Japan Esophageal Society were searched using the search terms: “(esophagus OR esophageal) AND sentinel”. The outcomes of interest were the detection rate and sensitivity. Overall, 18 studies were included. The pooled detection rate was 89.2 % [82.6–93.5]. Patients with T1 and two tumors had a 17 % higher detection rate compared to those with T3 and four tumors. The pooled sensitivity was 84 % [78–88 %]. The sensitivity was higher for adenocarcinoma compared to squamous cell carcinoma (SCC) (91 vs. 81 %). In the SCC patients, there was a trend toward decreased sensitivity associated with an increasing tumor depth (T1:88 %, T2:76 %, T3:50 %). Our analysis indicated that sentinel node biopsy is useful in adenocarcinoma patients. For SCC patients, including only cN0 patients (preferably T1 and 2) would increase the detection rate and sensitivity. Due to the limited number of high-quality studies, drawing any more definite conclusions is impossible. Large cohort studies with a standardized and consistent design will be needed in the future.
KeywordsEsophagus Esophageal Sentinel False negative rate Detection rate Systematic review
This study is derived from a residency thesis under the approval number of 89834, which was conducted in the Nuclear Medicine Research Center and Minimally Invasive and Endoscopic Surgery Research Center of Mashhad University of Medical Sciences.
Conflict of interest
The authors declare no conflicts of interest.
- 8.Oxford Center for Evidence Based Medicine checklist of the diagnostic studies. http://www.cebm.net/index.aspx?o=1025. Accessed Apr 2011.
- 18.Stein HJ, Burian M, Feith M, Piert M, Naehrig J, Siewert JR. First experience with sentinel lymphadenectomy in early adenocarcinoma of the distal esophagus and esophagogastric junction. Gastroenterology. 2004;126:769.Google Scholar
- 19.Lemstra C, Plukker JTM, van Westreenen HL, van Dullemen HM, Jager PL. A feasibility study of sentinel lymph node scintigraphy in staging of esophageal cancer. Eur J Nucl Med Mol Imaging. 2004;31:S267.Google Scholar
- 22.Neoral C, Aujesky R, Vrba R, Bohanes T, Kral V, Klein J, et al. The sentinel lymph node in carcinoma of the distal esophagus and cardia. Klinická Onkologie. 2006;16:305–9.Google Scholar