Sentinel Lymph Node Biopsy in Endometrial Cancer – A Systematic Review and Quality Assessment of Meta-Analyses

Mariño, Mario Arturo González

doi:10.1055/s-0042-1749067

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Brasil

Revista Brasileira de Ginecologia e Obstetrícia

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Brasil

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Sumário

Review Article • Rev Bras Ginecol Obstet. 44 (08) • 2022 • https://doi.org/10.1055/s-0042-1749067 copy

Sentinel Lymph Node Biopsy in Endometrial Cancer – A Systematic Review and Quality Assessment of Meta-Analyses

Biópsia do linfonodo sentinela no câncer de endométrio – Uma revisão sistemática e avaliação da qualidade de meta-análises

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To assess the quality of recent meta-analyses reviewing the diagnostic utility of sentinel node biopsy in endometrial cancer.

Methods

With the MeSH terms endometrial neoplasms and sentinel lymph node biopsy, PubMed and Embase databases were searched on October 21, 2020, and again on November 10, 2021, with meta-analysis and publication date filters set to since 2015. The articles included were classified with the A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) assessment tool.

Results

The database searches found 17, 7 of which, after the screening, were selected for full review by the author, finally extracting six meta-analyzes for quality analysis. The rating with the AMSTAR 2 assessment tool found that overall confidence in their results was critically low.

Conclusion

This study found that the quality of recent meta-analyses on the utility of the staging of endometrial cancer with sentinel node biopsy, evaluated by the AMSTAR 2 assessment tool, is classified as critically low, and, therefore, these meta-analyses are not reliable in the summary of their studies.

Keywords
neoplasms; uterus; endometrium; sentinel lymph node; biopsy; endometrial neoplasms

Author	Detection rate (%) (95% CI)	Sensitivity (%) (95% CI)
Marchocki et al.¹²12 Marchocki Z, Cusimano MC, Clarfield L, Kim SR, Fazelzad R, Espin- Garcia O, et al. Sentinel lymph node biopsy in high-grade endometrial cancer: a systematic review and meta-analysis of performance characteristics. Am J Obstet Gynecol. 2021;225(04):367. e1–367.e39. Doi: 10.1016/j.ajog.2021.05.034 https://doi.org/10.1016/j.ajog.2021.05.0...	91 (85–95)	92 (84–96)
Wang and Liu¹³13 Wang L, Liu F. Meta-analysis of laparoscopy sentinel lymph node mapping in endometrial cancer. Arch Gynecol Obstet. 2018;298 (03):505–510. Doi: 10.1007/s00404-018-4845-y https://doi.org/10.1007/s00404-018-4845-...	96 (95–98)	96.3 (94–98)
Lin et al.¹⁴14 Lin H, Ding Z, Kota VG, Zhang X, Zhou J. Sentinel lymph node mapping in endometrial cancer: a systematic review and metaanalysis. Oncotarget. 2017;8(28):46601–46610. Doi: 10.18632/ oncotarget.16662 https://doi.org/10.18632/oncotarget.1666...	83 (80–86)	91 (87–95)
Bodurtha Smith et al.¹⁵15 Bodurtha Smith AJ, Fader AN, Tanner EJ. Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216(05):459–476.e10. Doi: 10.1016/j.ajog.2016.11.1033 https://doi.org/10.1016/j.ajog.2016.11.1...	81 (77–84)	96 (91–98)

Author	Pelvic nodes Odds ratio (95% CI)	Paraortic nodes Odds ratio (95% CI)
Gu et al.¹⁶16 Gu Y, Cheng H, Zong L, Kong Y, Xiang Y. Operative and oncological outcomes comparing sentinel node mapping and systematic lymphadenectomy in endometrial cancer staging: meta-analysis with trial sequential analysis. Front Oncol. 2021;10:580128. Doi: 10.3389/fonc.2020.580128 https://doi.org/10.3389/fonc.2020.580128...	2.00 (1.21–3.32); p= 0.007	0.62 (0.24–1.64); p= 0.34
Bogani et al.¹⁷17 Bogani G, Murgia F, Ditto A, Raspagliesi F. Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol. 2019;153(03):676–683. Doi: 10.1016/j.ygyno.2019.03.254 https://doi.org/10.1016/j.ygyno.2019.03....	2.03 (1.30–3.18); p= 0.002	0,93 (0,39–2.18); p= 0.86

Question/author	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	Classification
Marchocki et al.¹²12 Marchocki Z, Cusimano MC, Clarfield L, Kim SR, Fazelzad R, Espin- Garcia O, et al. Sentinel lymph node biopsy in high-grade endometrial cancer: a systematic review and meta-analysis of performance characteristics. Am J Obstet Gynecol. 2021;225(04):367. e1–367.e39. Doi: 10.1016/j.ajog.2021.05.034 https://doi.org/10.1016/j.ajog.2021.05.0...	Y	Y	N	N	Y	N	Y	Y	N	N	N	N	N	N	N	Y	CL
Wang and Liu¹³13 Wang L, Liu F. Meta-analysis of laparoscopy sentinel lymph node mapping in endometrial cancer. Arch Gynecol Obstet. 2018;298 (03):505–510. Doi: 10.1007/s00404-018-4845-y https://doi.org/10.1007/s00404-018-4845-...	Y	N	N	N	Y	Y	N	N	P	N	Y	Y	N	N	Y	Y	CL
Lin et al.¹⁴14 Lin H, Ding Z, Kota VG, Zhang X, Zhou J. Sentinel lymph node mapping in endometrial cancer: a systematic review and metaanalysis. Oncotarget. 2017;8(28):46601–46610. Doi: 10.18632/ oncotarget.16662 https://doi.org/10.18632/oncotarget.1666...	N	N	N	N	Y	Y	N	P	P	N	N	N	N	N	N	N	CL
Bodurtha Smith et al.¹⁵15 Bodurtha Smith AJ, Fader AN, Tanner EJ. Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216(05):459–476.e10. Doi: 10.1016/j.ajog.2016.11.1033 https://doi.org/10.1016/j.ajog.2016.11.1...	N	Y	N	N	Y	Y	N	Y	P	N	N	N	Y	Y	N	Y	CL
Gu et al.¹⁶16 Gu Y, Cheng H, Zong L, Kong Y, Xiang Y. Operative and oncological outcomes comparing sentinel node mapping and systematic lymphadenectomy in endometrial cancer staging: meta-analysis with trial sequential analysis. Front Oncol. 2021;10:580128. Doi: 10.3389/fonc.2020.580128 https://doi.org/10.3389/fonc.2020.580128...	Y	Y	N	N	Y	Y	Y	N	N	N	N	N	N	N	N	Y	CL
Bogani et al.¹⁷17 Bogani G, Murgia F, Ditto A, Raspagliesi F. Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol. 2019;153(03):676–683. Doi: 10.1016/j.ygyno.2019.03.254 https://doi.org/10.1016/j.ygyno.2019.03....	Y	P	N	P	N	N	Y	Y	N	N	N	N	N	N	N	Y	CL

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[1] Address for correspondence Mario Arturo González Mariño, KR 30 # 45-03 - Campus: Universitario - Edificio: 471 - Piso: 1, Bogotá, Colombia (marioar90@hotmail.com).