| Objective:Endometrial cancer is a common malignant tumor of the female reproductive system.Since the systematic lymphadenectomy was included in the routine treatment of endometrial cancer,comprehensive evaluation of lymph nodes has been the recommended treatment standard.However,in the clinical treatment of early endometrial cancer,the appropriate scope of lymph node resection is still controversial.Sentinel lymph node biopsy in endometrial cancer is a modern technique and is increasingly used in the staging of endometrial cancer.This paper intends to conduct a systematic review of the published literature,to obtain quantitative evaluation results,and jointly discuss the role and application value of sentinel lymph node biopsy in the surgical treatment of early endometrial cancer,so as to provide evidence-based medicine reference for its clinical application and promotion.Methods:To retrieve the literature by searching English databases such as Pubmed,EMbase,The Cochrane Library,and Chinese databases such as CNKI,Wan fang data,VIP data,CBM and so on.The language were limited to Chinese and English.The retrival time ranges from the time when the database was built to January 31,2020.Strict selection,evaluation and synthesis of the searched literatures in accordance with the established inclusion and exclusion criteria.Sentinel lymph node biopsy was performed in the test group,and lymph node resection was performed in the control group.The final included studies were analyzed using Review Mananger5.3 software.Result:A total of 13 retrospective cohort studies were eventually included,with a totalnumber of 5581 cases.The quality of the literatures was evaluated by the NOS scale,all of which were> 5 points and conformed the standard.The statistical analysis of the extracted data shows that the sentinel lymph node resection group and the lymph node dissection group were:1.3 years disease-free survival rate,the combined OR = 1.26,95% CI [0.73,2.15],P = 0.41,the difference was not statistically significant;.2.Total recurrence rate,the combined OR = 0.76,95% CI [0.59,0.98],P = 0.04,the difference was statistically significant.3.Disease-related mortality rate,the combined OR = 0.70,95% CI [0.39,1.23],P = 0.21,the difference was not statistically significant.4.The detcetion rate of positive pelvic lymph node,the combined OR = 2.78,95% CI [1.99,3.90],P <0.00001,the difference was statistically significant;5.The detection rate of positive para-aortic lymph node,the combined OR = 1.52,95 % CI [0.75,3.10],P =0.25,the difference was not statistically significant;6.Adjuvant treatment rate,the combined OR = 0.89,95% CI [0.40] 1.98],P = 0.78,the difference was not statistically significant.7.Chemotherapy rate,the combined OR = 1.33,95% CI [1.09,1.63],P = 0.006,the difference was statistically significant.8.Radiotherapy rate,the combined OR = 1.18,95% CI [0.91,1.53],P = 0.22,the difference was no significant difference.9.Intraoperative blood loss,the combined MD =-50.05,95% CI [-53.51],-46.60],P <0.00001,the difference was statistically significant.10.The incidence of intraoperative complications,the combined OR = 0.19,95% CI [0.04,0.85],P = 0.03,the difference was statistically significant.11.The incidence of complications at 30 days,the combined with OR = 0.48,95% CI [0.32,0.74],P = 0.0008,the difference was statistically significant.12.The rate of lower-limb lymphedema,the combined with OR = 0.06,95% CI [0.01,0.29],P = 0.0006,the difference was statistically significant.Conclusions:1.Compared to lymph node dissection,the sentinel lymph node biopsy in the surgical treatment of early endometrial cancer significantly reduces the total recurrence rate,and shorten the operation time,reduce the amount of intraoperative bleeding,reduce the occurrence of intraoperative and postoperative complicationsrate,can also guide postoperative chemotherapy.2.The application of sentinel lymph node biopsy did not affect the survival rate,mortality,postoperative adjuvant therapy and radiotherapy rate of patients with endometrial cancer. |
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