The role of sentinel lymph node biopsy in select sarcoma patients: a meta-analysis

Am J Surg. 2012 Oct;204(4):428-33. doi: 10.1016/j.amjsurg.2011.12.019. Epub 2012 May 11.

Abstract

Background: Sentinel lymph node (SLN) biopsy is a staging technique for occult lymph node disease. SLN biopsy has been applied to select patients with sarcoma, although the clinical utility remains uncertain.

Methods: A PubMed/MEDLINE literature search was performed, and SLN biopsy outcomes were analyzed using a Bayesian meta-analytic approach to obtain point and interval estimates of rates of interest.

Results: Sixteen studies involving SLN biopsy in patients with sarcoma were identified. Of 114 patients reported, 14 patients had positive SLNs (crude estimate, 12%; meta-analysis estimate, 17%). The meta-analysis false-negative rate was 29% (95% credible interval, 5%-59%). Recurrence and death rates in the SLN-positive group were higher than in the SLN-negative group.

Conclusions: This investigation highlights the current role of SLN biopsy in select patients with sarcoma for tumor staging. Questions regarding the high false-negative rate and management of micrometastatic lymphatic disease in patients with sarcoma still exist.

Publication types

  • Meta-Analysis

MeSH terms

  • Bayes Theorem
  • False Negative Reactions
  • Humans
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Markov Chains
  • Monte Carlo Method
  • Rhabdomyosarcoma / pathology
  • Sarcoma / pathology*
  • Sarcoma / surgery
  • Sarcoma, Clear Cell / pathology
  • Sarcoma, Synovial / pathology
  • Sentinel Lymph Node Biopsy*