| Objective:The purpose of this study was to evaluate the clinical efficacy of sentinel lymph node biopsy(SLNB)compared with traditional pelvic lymphadenectomy(PLND)in the treatment of early cervical cancer(ECC).Methods:Through systematic retrieval of PubMed,Elsevier,EMBASE,Cochrane Library,Web of Science,MEDLINE,CNKI,CBM,Wanfang and VIP database,and setting the time limit from January 2000 to February 2020.The retrieval language was set up in both Chinese and English.Experimental or observational studies related to the clinical efficacy of SLNB in ECC were selected,which mainly included randomized controlled trials(RCT),Quasi-randomized controlled trial(QRCT),cohort study and case-control study.According to the inclusion and exclusion criteria to select the literature that meets the criteriaand.the included research literatures are traced to the relevant original as far as possible Initial data.Literature quality will be evaluated according to the evaluation items of JBI evidence-based health care center in Australia.and the study indexes were statistically analyzed using RenMan5.3software.Results:This study included 10 related literatures,6 in Chinese,4 in English,of which 6were randomized controlled trials and 4 quasi randomized controlled trial,with a total sample size of 2230 patients.Six articles reported the related data of SLNB combined with Radical hysterectomy(RH),and the control group was PLND combined with RH,the other three literatures were SLNB guided PLND combined with RH,and the control group was PLND combined with RH,there is also a literature report that the study group is SLNB combined with Radical trachelectomy(RT),and the controlgroup is PLND combined with RH.Compared with PLND group,SLNB group has a shorter operative time[SMD=-66.9,95%CI(-116.47,-16.91),P=0.009],The incidence of lymphocysts [SMD=0.12,95%CI(0.06,0.28),P<0.00001],perineal lower limb edema[SMD=0.15,95%CI(0.07,0.33),P<0.00001],intraoperative and postoperative complications [OR=0.21,95%CI(0.08,0.54),P=0.001] was lower.SLNB group lost less blood in open surgery Compared with PLND group [SMD =-95.63,95% CI(-110.02,-81.24),P < 0.00001].there was no significant difference among SLNB group and PLND group about the incidence of Postoperative urinary retention [SMD=1.31,95%CI(0.51,3.36),P=0.58],1-year recurrence rate,5-year recurrence rate [OR=0.75,95%CI(0.23,2.48),P=0.64],1-year Recurrence-free survival rate(RFS)[OR=1.42,95%CI(0.49,4.14),P=0.52],3-year RFS [OR=0.65,95%CI(0.36,1.18)and 5-year RFS [OR=0.94,95%CI(0.54,1.64),P=0.84].There was no significant difference in the operation time [SMD=-14.16,95%CI(-25.49,53.8),P=0.48] between the PLND group and the PLND group under SLNB guidance,but the amount of intraoperative bleeding [SMD=-41.85,95%CI(-60.88,-22.81),P<0.0001]in the latter group was less.Conclusion:1.This study suggested that compared with the PLND group,for SLN negative patients,the SLNB group had shorter operative time,lower incidence of lymphocele and perineal lower limb edema,lower incidence of intraoperative and postoperative complications,SLNB group lost less blood in open surgery Compared with PLND group,Moreover,there was no significant difference in the incidence of urinary retention,recurrence rate and survival rate between the two groups.2.There was no significant difference in the operation time between the PLND group and the PLND group under SLNB guidance,but less intraoperative bleeding in the latter group.Therefore,through the comprehensive evaluation of this study,SLNB is considered to be a precise and efficient surgical method that avoids the adverse effects of "casting a wide net" on patients,but its safety and long-term efficacy stillrequires comprehensive and in-depth scientific evaluation in a multicentre,largesample prospective randomized controlled study. |
