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Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update

A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We perfo...

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Autores principales: Liss, Michael A., Noguchi, Jonathan, Lee, Hak J., Vera, David R., Kader, A. Karim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495490/
https://www.ncbi.nlm.nih.gov/pubmed/26166959
http://dx.doi.org/10.4103/0970-1591.159601
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author Liss, Michael A.
Noguchi, Jonathan
Lee, Hak J.
Vera, David R.
Kader, A. Karim
author_facet Liss, Michael A.
Noguchi, Jonathan
Lee, Hak J.
Vera, David R.
Kader, A. Karim
author_sort Liss, Michael A.
collection PubMed
description A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We performed a systematic search of PubMed for both human and animal studies that looked at SLN detection in cases of urothelial carcinoma of the bladder. We identified a total of nine studies that assessed a variety of imaging techniques to identify SLNs in patients with urothelial carcinoma of the bladder. Eight studies investigated human patients while one looked at animal (dog) models. Seven studies representing 156 patients noted the negative predictive value of the SLN to predict a metastasis free state was 92% (92/100). The SLN biopsy was less accurate in metastatic patients with a positive predictive value of only 77% (43/56) with a false negative range of in individual studies of 0-19%. Clinically, positive nodes routinely do not take up the pharmaceutical agent for SLN. Therefore, SLN biopsy is a promising concept with a 92% negative predictive value; however, the false negative rates are high which may be improved by standardizing populations and indications. Novel technologies are improving the detection of SLN and may provide the surgeon with an improved ability to detect micrometastasis, guide surgery, and reduce patient morbidity.
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spelling pubmed-44954902015-07-12 Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update Liss, Michael A. Noguchi, Jonathan Lee, Hak J. Vera, David R. Kader, A. Karim Indian J Urol Review Article A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We performed a systematic search of PubMed for both human and animal studies that looked at SLN detection in cases of urothelial carcinoma of the bladder. We identified a total of nine studies that assessed a variety of imaging techniques to identify SLNs in patients with urothelial carcinoma of the bladder. Eight studies investigated human patients while one looked at animal (dog) models. Seven studies representing 156 patients noted the negative predictive value of the SLN to predict a metastasis free state was 92% (92/100). The SLN biopsy was less accurate in metastatic patients with a positive predictive value of only 77% (43/56) with a false negative range of in individual studies of 0-19%. Clinically, positive nodes routinely do not take up the pharmaceutical agent for SLN. Therefore, SLN biopsy is a promising concept with a 92% negative predictive value; however, the false negative rates are high which may be improved by standardizing populations and indications. Novel technologies are improving the detection of SLN and may provide the surgeon with an improved ability to detect micrometastasis, guide surgery, and reduce patient morbidity. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4495490/ /pubmed/26166959 http://dx.doi.org/10.4103/0970-1591.159601 Text en Copyright: © Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Liss, Michael A.
Noguchi, Jonathan
Lee, Hak J.
Vera, David R.
Kader, A. Karim
Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update
title Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update
title_full Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update
title_fullStr Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update
title_full_unstemmed Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update
title_short Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update
title_sort sentinel lymph node biopsy in bladder cancer: systematic review and technology update
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495490/
https://www.ncbi.nlm.nih.gov/pubmed/26166959
http://dx.doi.org/10.4103/0970-1591.159601
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