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Performance of indocyanine green in sentinel lymph node mapping and lymph node metastasis in penile cancer: systematic review, meta-analysis, and single-center experience

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Abstract

Purpose

The aim of this study was to investigate the overall sensitivity and specificity of indocyanine green (ICG)-near-infrared (NIR) fluorescence imaging in the detection of sentinel lymph node metastasis (SLNM) in penile cancer.

Methods

We searched PubMed, Embase, Web of Science, Scopus, and the Cochrane Library databases to identify manuscripts where ICG was intravenously administered prior to or during penile cancer surgery, with no restriction on language or publication status. The results extracted are presented as forest plots.

Results

Seven studies were included in the analysis. The median sensitivity and specificity of ICG-NIR imaging for SLNM detection were 100 and 4%, respectively; the pooled sensitivity was 100.0% (95% confidence interval [CI] 97.0–100.0) and specificity was 2.0% (95% CI 1.0–3.0). There was no significant difference in the diagnostic results between different injection sites and doses in each experimental group.

Conclusion

To our knowledge, this meta-analysis is the first to summarize the diagnostic performance of ICG-NIR imaging for SLNM detection in penile cancer. ICG is sensitive in the imaging of SLN tissue, which can consequently improve the accuracy of lymph node detection. However, the specificity is very low.

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Data Availability

Date related to this article can be obtained from the corresponding author on request.

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Funding

This work was supported by the Special Fund for Research on National Major Research Instruments of China (Grant No. 62027824) and the Central Guidance on Local Science and Technology Development Fund of Shanxi Province (No. YDZJSX2021C010).

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Authors and Affiliations

  1. Institute of Medical Technology, Peking University Health Science Center, Beijing, 100080, China

    Rui Zhang, Sihan Dong & Xunbin Wei

  2. First Clinical Medical College, Nanjing Medical University, Nanjing, 210000, China

    Yaqin Zhang

  3. Instrument Science and Opto-Electronics Engineering, Beijing Information Science and Technology University, Beijing, 100192, China

    Kai Pang

  4. Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, China

    Xiaofeng Yang

  5. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China

    Xunbin Wei

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  1. Rui Zhang
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Contributions

RZ: project development, data collection, manuscript writing. YZ: project development, data collection, data analysis. SD: data collection, data analysis. KP: project development, manuscript writing. XY: data collection. XW: manuscript writing.

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Correspondence to Xunbin Wei.

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Zhang, R., Zhang, Y., Dong, S. et al. Performance of indocyanine green in sentinel lymph node mapping and lymph node metastasis in penile cancer: systematic review, meta-analysis, and single-center experience. World J Urol 41, 2319–2326 (2023). https://doi.org/10.1007/s00345-023-04485-x

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