Is the sentinel node biopsy clinically applicable for limited lymphadenectomy and modified gastric resection in gastric cancer? A meta-analysis of feasibility studies.

Abstract:

BACKGROUND:Sentinel node biopsies (SNBs) have been clinically applied in melanoma and breast cancer for limited lymphadenectomy. However, the use of SNB remains controversial in gastric cancer due to unsatisfactory sensitivity and variability. This meta-analysis was performed to determine the sensitivity of SNB in gastric cancer and to identify factors that improve its sensitivity. METHODS:Feasibility studies on SNB in gastric cancer were searched for from 2001 to 2009 in Pubmed, Cochrane, and Embase. Forty-six reports, which included 2,684 patients, were found. Estimated sensitivities, detection rates, and negative (NPV), and positive predictive values (PPV) were calculated using a random effects model. Inter-study heterogeneity, meta-regression, and subgroup analysis for sensitivity was performed. RESULTS:The estimated sensitivity, detection rate, NPV, and PPV were 87.8%, 97.5%, 91.8%, and 38.0%, respectively, with significant inter-study heterogeneity (P < 0.0001). However, no significant contributor to heterogeneity was identified. By subgroup analysis, sensitivity was found to depend significantly on the number of SNs harvested. CONCLUSIONS:SNB in gastric cancer is probably not clinically applicable for limited lymphadenectomy due its unsatisfactory sensitivity and heterogeneity between practicing surgeons. To improve sensitivity, more than four SNs should be harvested, and a tumor specific SNB method should be developed.

journal_name

J Surg Oncol

authors

Ryu KW,Eom BW,Nam BH,Lee JH,Kook MC,Choi IJ,Kim YW

doi

10.1002/jso.21995

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

578-84

issue

6

eissn

0022-4790

issn

1096-9098

journal_volume

104

pub_type

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