Sentinel Lymph Node Mapping in High-Risk Endometrial Cancer: a Systematic Review and Meta-Analysis

Abstract

Background: In the staging of endometrial cancer (EC), the role of sentinel lymph node (SLN) mapping for high-risk EC is still unclear. Methods: Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. English studies published in PubMed, Embase, and Cochrane Library before 20th SEP, 2019 were retrieved to perform a systematic evaluation and meta-analysis which evaluate the detection rate and diagnostic accuracy of SLN mapping in high-risk EC. Statistical analysis was conducted using stata14.0 software. Results: A total of 12 studies were included, including 758 high-risk EC patients. The detection rate of SLN mapping was 84.8% (95% CI, 79.9–89.6%). The pooled bilateral detection rate was 67.0% (95% CI, 56.8–77.3%). The pooled para-aortic detection rate was 8.4% (95% CI, 1.8–14.9%). The pooled sensitivity was 87% (95% CI, 79–92%), and the pooled specificity was 98% (95% CI, 96–99%). Pooled negative predictive value (NPV) was 97.7% (95% CI, 96.4–99.1%), AUC =0.99 (95% CI, 0.97–0.099). Conclusions: SLN mapping still has a high detection rate and diagnostic accuracy in high-risk EC. SLN mapping is a reliable alternative to systematic lymph node dissection, but its prognostic effect on high-risk EC is yet to be further studied and verified by large sample studies.