Sentinel Node Biopsy in Urothelial Carcinoma of the Bladder: Systematic Review and Meta-Analysis.

To determine the application of sentinel node biopsy in urothelial carcinoma of the bladder, we performed a systematic review and meta-analysis.

Pooled false negative rate and detection rate were presented using Meta-Disc (version 1. 4), and comprehensive meta-analysis (version 2). Publication bias and heterogeneity were assessed using funnel plot, Cochrane Q test, and I2 index.

The pooled detection rate was 91% (95% CI 87-93%) and pooled sensitivity was 79% (95% CI 0.69-0.86%). When the neoadjuvant chemotherapy group of patients was omitted, the pooled sensitivity changed to 82% (95% CI 74-88%), and the Cochrane Q and I2 statistics were 15.44 and 48.2%, respectively. The pooled sensitivity of studies that included > 50% of pT 3 or 4 patients was 70% (59-80), by omitting studies that enrolled > 50% of patients at pT stage of 3 or 4, the pooled sensitivity increased to 93% (81-98).

Although the studies on SN biopsy of muscle invasive bladder cancer patients resulted in a high detection rate and sensitivity, further validated multicenter trials with larger sample size are essential to confirm the reliability and accuracy of this approach and obtain a standardized method. We showed that pT1 or pT2 bladder cancer patients with clinically negative lymph nodes are the most appropriated group for sentinel lymph node mapping.

Urologia internationalis. 2019 Mar 05 [Epub ahead of print]

Leili Zarifmahmoudi, Hamidreza Ghorbani, Kayvan Sadri, Mahmoud Tavakkoli, Maliheh Keshvari, Maryam Salehi, Ramin Sadeghi

Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, .