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Sentinel Node Proce...
Sentinel Node Procedure in Prostate Cancer : A Systematic Review to Assess Diagnostic Accuracy
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- Wit, Esther M K (author)
- Netherlands Cancer Institute
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- Acar, Cenk (author)
- Eryaman Hospital
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- Grivas, Nikolaos (author)
- Netherlands Cancer Institute
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- Yuan, Cathy (author)
- University of Aberdeen
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- Horenblas, Simon (author)
- Netherlands Cancer Institute
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- Liedberg, Fredrik (author)
- Lund University,Lunds universitet,Bröstcancer-genetik,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Institutionen för translationell medicin,Breastcancer-genetics,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Translational Medicine,Skåne University Hospital
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- Valdes Olmos, Renato A. (author)
- Leiden University Medical Centre
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- van Leeuwen, Fijs W B (author)
- Leiden University Medical Centre
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- van den Berg, Nynke S. (author)
- Leiden University Medical Centre
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- Winter, Alexander (author)
- Carl von Ossietzky University of Oldenburg
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- Wawroschek, Friedhelm (author)
- Carl von Ossietzky University of Oldenburg
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- Hruby, Stephan (author)
- Paracelsus Private Medical University of Salzburg
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- Janetschek, Günter (author)
- Paracelsus Private Medical University of Salzburg
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- Vidal-Sicart, Sergi (author)
- Hospital Clínic of Barcelona
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- MacLennan, Steven (author)
- University of Aberdeen
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- Lam, Thomas B. (author)
- University of Aberdeen
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- van der Poel, Henk G. (author)
- Netherlands Cancer Institute
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(creator_code:org_t)
- Elsevier BV, 2017
- 2017
- English.
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In: European Urology. - : Elsevier BV. - 0302-2838. ; 71:4, s. 596-605
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Abstract
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- Context: Extended pelvic lymph node dissection (ePLND) is the gold standard for detecting lymph node (LN) metastases in prostate cancer (PCa). The benefit of sentinel node biopsy (SNB), which is the first draining LN as assessed by imaging of locally injected tracers, remains controversial. Objective: To assess the diagnostic accuracy of SNB in PCa. Evidence acquisition: A systematic literature search of Medline, Embase, and the Cochrane Library (1999-2016) was undertaken using PRISMA guidelines. All studies of SNB in men with PCa using PLND as reference standard were included. The primary outcomes were the nondiagnostic rate (NDR), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false positive (FP) and false negative (FN) rates. Relevant sensitivity analyses based on SN definitions, ePLND as reference standard, and disease risk were undertaken, including a risk of bias (RoB) assessment. Evidence synthesis: Of 373 articles identified, 21 studies recruiting a total of 2509 patients were eligible for inclusion. Median cumulative percentage (interquartile range) results were 4.1% (1.5-10.7%) for NDR, 95.2% (81.8-100%) for sensitivity, 100% (95.0-100%) for specificity, 100% (87.0-100%) for PPV, 98.0% (94.3-100%) for NPV, 0% (0-5.0%) for the FP rate, and 4.8% (0-18.2%) for the FN rate. The findings did not change significantly on sensitivity analyses. Most studies (17/22) had low RoB for index test and reference standard domains. Conclusions: SNB appears to have diagnostic accuracy comparable to ePLND, with high sensitivity, specificity, PPV and NPV, and a low FN rate. With a low FP rate (rate of detecting positive nodes outside the ePLND template), SNB may not have any additional diagnostic value over and above ePLND, although SNB appears to increase nodal yield by increasing the number of affected nodes when combined with ePLND. Thus, in high-risk disease it may be prudent to combine ePLND with SNB. Patient summary: This literature review showed a high diagnostic accuracy for sentinel node biopsy in detecting positive lymph nodes in prostate cancer, but further studies are needed to explore the effect of sentinel node biopsy on complications and oncologic outcome. The accuracy of sentinel node biopsy (SNB) in detecting positive lymph nodes in prostate cancer appears to have diagnostic accuracy comparable to that of extended pelvic lymph node dissection (ePLND). However, SNB may not have any additional diagnostic value over and above ePLND.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Diagnostic accuracy
- Pelvic lymph node dissection
- Prostate cancer
- Sentinel node
- Systematic review
- Targeted lymph node biopsy
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- By the author/editor
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Wit, Esther M K
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Acar, Cenk
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Grivas, Nikolaos
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Yuan, Cathy
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Horenblas, Simon
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Liedberg, Fredri ...
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show more...
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Valdes Olmos, Re ...
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van Leeuwen, Fij ...
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van den Berg, Ny ...
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Winter, Alexande ...
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Wawroschek, Frie ...
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Hruby, Stephan
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Janetschek, Günt ...
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Vidal-Sicart, Se ...
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MacLennan, Steve ...
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Lam, Thomas B.
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van der Poel, He ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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European Urology
- By the university
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Lund University