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3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of Nuclear Congress Medicine of Nuclear Medicine Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011 Accuracy of sentinel lymph node biopsy for axillary staging of breast cancer patients undergone prior surgical biopsy: metaanalysis of the literature. Ramin Sadeghi 1 , Hassan Gholami 2 , Hadi Javan 3 , Azar Fani Pakdel 4 , Mehdi Asadi 5 1 Mash’had University of Medical Science, Nuclear Medicine Research Center 2 Mash’had University of Medical Science, Evidence Based Medicine Committee 3 Mashhad University of Medical Sciences 4 Mash’had University of Medical Science, Cancer Research Center 5 Mash’had University of Medical Science, Surgical Oncology Research Center Introduction: Sentinel lymph node biopsy is the standard method of axillary staging in early stage breast cancer patients. An important issue is the eligibility of patients undergone prior surgical biopsy of the primary breast lesion. In this meta-analysis we comprehensively searched the literature regarding this issue and summarized the results accordingly. Materials and methods: We systematically searched Medline, SCOPUS, and Google Scholar for studies with head to head comparison of sentinel lymph node biopsy method in patients with and without prior surgical biopsy. No language or date restriction was imposed. Studies with enough information to calculate detection rate as well as false negative rate for both groups were included. For pooling of the results random effects model was used (Der-Simonian and Laird method). Q statistics and I2 index were used for heterogeneity evaluation. Results: 68 studies for detection rate and 16 for false negative rate were located with the required information. Pooled detection rates for patients with and without history of prior surgical biopsy were 91.33% [89.1-93%] and 92.7% [90.9-94.1%] respectively. OR of unsuccessful mapping was 1.14 [0.955-1.362] and risk difference was 0.00018 [-0.00844-0.00881] (Q value=104.730 p=0.001 and I2=38.89). Pooled false negative rates for patients with and without history of prior surgical biopsy were 13% [9.6%-17.4%] and 10% [7.6%-12.8%] respectively. OR of getting false negative results was 1.418 [1.107-1.816] and risk difference was 2.2% [0.1%-4.3%] (Q value=14.12 p=0.516 and I2=0). Conclusion: Successful sentinel node mapping is not decreased by prior surgical biopsy of the primary breast lesion. However, the false negative rate in this group of patients is slightly higher compared to those without previous biopsy. Despite this fact, the difference is low (2.2%) and is not clinically relevant. In our opinion prior biopsy of the primary breast lesions should not be considered as a contraindication for sentinel lymph node biopsy procedure. Keywords: Sentinel breast cancer, meta-analysis, core-needlebiopsy, excisional-biopsy 52
3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of Congress of Nuclear Medicine Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011 Sentinel node mapping in the prostate cancer: systematic review and meta-analysis of the literature Ramin Sadeghi 1 , Hassan Gholami 2 , Kamyar Tavakkoli Tabasi 3 , Asieh Sadat Fattahi Masoom 4 1 Mash’had University of Medical Science, Nuclear Medicine Research Center 2 Mash’had University of Medical Science, Education Management 3 Mash’had University of Medical Science, Urology Department 4 Mash’had University of Medical Science, General Surgery Department Aim: Sentinel node (SN) biopsy is becoming a standard procedure in the management of several malignancies. Several groups have evaluated the feasibility and value of this procedure in prostate cancer patients. In the current meta-analysis, we comprehensively and quantitatively summarized the results of these studies. Methods: Several databases including Medline, SCOPUS, Google Scholar, Ovid, Springer, and Science direct were systematically searched for the relevant studies regarding SL biopsy in the prostate cancer (prostate AND sentinel as search keywords). The outcomes of interest were sensitivity and detection rate of the procedure. Results: For detection rate and sensitivity 21 and 16 studies met the criteria of inclusion respectively. Pooled detection rate was 93.8% (95% CI 89-96.6%). Cochrane Q value was 216.077 (I2 = 89.81% and p < 0.001). Pooled sensitivity was 94% (95% CI 91-96%). Cochrane Q value was 14.12 (I2 = 0.0 and p = 0.516). Conclusion: SL biopsy can prevent unnecessary pelvic lymph node dissection in prostate cancer patients. This procedure is feasible with low false negative rate and high detection rate. Keywords: Prostate-cancer, sentinel, systematic-review, metaanalysis 53
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