Sentinel lymph node biopsy: state of art, evidence base and recommendations (literature review)

Authors

  • O.V. Postupalenko Bogomolets National Medical University, Kyiv, Ukraine,

DOI:

https://doi.org/10.22141/oncology.1.1.2018.155378

Keywords:

sentinel lymph node, biopsy, surgical treatment, re­commendations, review

Abstract

Background. Sentinel lymph node (SLN) concept is the area of active research due to its perspectives for oncosurgery, which allows individualizing treatment approaches to the cancer patients. The purpose of the study was the review of the European Society for Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN) guidelines, publications in the Cochrane Library on the oncological efficacy of SLN and traditional lymph node dissection in the treatment of primary solid cancers. Materials and methods. Current ESMO and NCCN guidelines, publications in the Cochrane Library are given, in which the concept of SLN and its place beside the traditional approach of lymph node dissection are considered in the aspect of surgical treatment. Results. Three Cochrane reviews, 7 ESMO and NCCN recommendations were found. Combined methods (dye + radiocolloid) were the most informative for SLN identification in the cervical, axillary or inguinal­femoral area, fluorescents — in the pelvic cavity and abdomen. Investigation of frozen sections in skin melanoma is not recommended, and is indicated in cervical cancer. Immunohistochemistry of SLN is mandatory for penile cancer and melanoma, but not relevant in breast cancer. A common point of view regar­ding cancer patients is the need for a biopsy (fine needle aspiration, core needle or excisional biopsy) in case of suspected metastatic lesion of lymph nodes and for lymphadenopathy. The absence of enhanced SLN is an indication for the application of traditional approaches to lymph node dissection in relevant oncological pathology. Conclusions. The discrepancies in the conclusions and recommendations of the analyzed literature are explained by the use of the results of various studies as output data. The NCCN guidelines, with their constant dynamic updates, contain the most up­to­date information. Taking into account the active development of SLN concept, the results of trails accumulated over several years allow changing the views on its place in the treatment of oncological di­seases. The ESMO guidelines and the Cochrane Library reviews on SLN are already more of historical significance and in most cases, their application requires a critical approach based on the results of research and meta­analyzes that were published later.

References

Bromham N., Schmidt-Hansen M., Astin M., Hasler E., Reed M.W. Axillary treatment for operable primary breast cancer // Cochrane Database Syst. Rev. — 2017 Jan 4. — 1. — CD004561. — doi: 10.1002/14651858.

Senkus E., Kyriakides S., Ohno S. et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. — 2015 Sep. — 26(Suppl. 5). — Р. 8-30. — doi: 10.1093/annonc/mdv298.

Cardoso F., Senkus E., Costa A. et al. 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4) // Ann. Oncol. — 2018 Aug 1. — 29(8). — Р. 1634-1657. — doi: 10.1093/annonc/mdy192.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Breast Cancer, version 1, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: March 20, 2018.

Marth C., Landoni F., Mahner S. et al. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. — 2017 Jul 1. — 28(Suppl. 4). — Р. 72-83. — doi: 10.1093/annonc/mdx220.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Cervical Cancer, version 1, 2019. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: August 9, 2018.

Colombo N., Preti E., Landoni F. et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. — 2013 Oct. — 24(Suppl. 6). — Р. 33-8.

Colombo N., Creutzberg C., Amant F. et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up // Ann. Oncol. — 2016 Jan. — 27(1). — Р. 16-41. — doi: 10.1093/annonc/mdt353.

National Comprehensive Cancer Network (NCCN) NCCN Clinical Practice Guidelines in Oncology: Uterine Neoplasms, version 2, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: May 25, 2018.

Lawrie T.A., Patel A., Martin-Hirsch P.P. et al. Sentinel node assessment for diagnosis of groin lymph node involvement in vulval cancer // Cochrane Database Syst. Rev. — 2014 Jun. — 27(6). — CD010409. — doi: 10.1002/14651858.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Vulvar Cancer (Squamous Cell Carcinoma), version 2, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: October 27, 2017.

Van Poppel H., Watkin N.A., Osanto S. et al. Penile cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. — 2013 Oct. — 24(Suppl. 6). — Р. 115-24. — doi: 10.1093/annonc/mdt286.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Penile Cancer, version 2, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: March 26, 2018.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers, version 2, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: June20, 2018.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Squamous Cell Skin Cancer, version 2, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: October 5. 2017.

Kyrgidis A., Tzellos T., Mocellin S. et al. Sentinel lymph node biopsy followed by lymph node dissection for localised primary cutaneous melanoma // Cochrane Database Syst. Rev. — 2015 May. — 16(5). — CD010307. — doi: 10.1002/14651858.

Dummer R., Hauschild A., Lindenblatt N. et al. Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. — 2015 Sep. — 26(Suppl. 5). — Р. 126-32. — doi: 10.1093/annonc/mdv297.

National Comprehensive Cancer Network (NCCN) NCCN Clinical Practice Guidelines in Oncology: Melanoma, version 3, 2018. — Available from: https://www.nccn.org/professionals/physician_gls/default.aspx#site Accessed: July 1, 2018.

Downloads

Issue

Vol. 1 No. 1 (2018)

Section

Review

License

Copyright (c) 2019 Practical oncology

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Our edition uses the copyright terms of Creative Commons for open access journals.

Authors, who are published in this journal, agree with the following terms:

  1. The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
  2. Directing  the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
  3. The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
  4. The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
  5. The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
  6. The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
  7. The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.