Mate Analysis Of Sentinel Lymph Node Biopsy In The Treatment Of Early Endometrial Cancer

Objective:Discuss the therapeutic effect of sentinel lymph node biopsy in early-stage endometrial cancer surgery,and further analyze whether sentinel lymph node biopsy can replace pelvic lymph node dissection to evaluate the status of pelvic and abdominal lymph node metastasis,so as to provide patients with endometrial cancer with more personalized and standardized treatment plan.Methods:This paper mainly retrieves the included literature by searching online Chinese and English databases（Pubmed,CNKI,etc.）.Secondly,supplemented by manual retrieval of the paper version of Obstetrics and Gynecology journals.Language restrictions: Chinese and English.The retrieval time is until December2021.Strictly follow the established inclusion criteria to screen the included literature,evaluate its quality,extract its data,and finally conduct a summary analysis of the obtained data.The sentinel lymph node biopsy group（experimental group,SLNB group）and pelvic lymph node ± para-aortic lymph node dissection group（control group,PLND group）were mainly compared.This paper conducts a pooled analysis by Rev Man 5.3.Results:After rigorous screening,a total of 15 high-quality scoring literature（all retrospective cohort studies）were included in this study,including a total of 3456 patients with endometrial cancer.After data extraction and data analysis,the results are as follows: 1.After the analysis of the total postoperative adjuvant treatment rate,there was no significant difference between the groups（OR=1.15,95%CI=[0.32,4.18],P=0.83）;2.postoperative radiotherapy rate（OR=0.87,95%CI=[0.52,1.64],P=0.60）,the difference was not statistically significant;3.postoperative vaginal brachytherapy rate（OR=1.23,95%CI）=[0.88,1.71],P=0.23),the difference was not statistically significant;4.Postoperative external beam therapy rate（OR=0.98,95%CI=[0.68,1.42],P=0.93）,the difference was not statistically significant;5.The postoperative chemotherapy rate（OR=1.06,95%CI=[0.78,1.45],P=0.69）,the difference was not statistically significant;6.Compared with the PLND group,the SLNB group reduced the overall postoperative disease recurrence rate（OR=0.70,95%CI=[0.53,0.91],P=0.007）,the difference was statistically significant;7.Compared with the PLND group,the SLNB group greatly reduced the postoperative local disease recurrence rate（OR=0.39,95 %CI=[0.25,0.63],P<0.0001）,the difference was statistically significant;8.postoperative distant metastasis recurrence rate（OR=0.83,95%CI=[0.57,1.21],P=0.34）,The difference was not statistically significant;9.the overall postoperative complication rate（OR=0.69,95%CI=[0.14,3.43],P=0.65）,the difference was not statistically significant;10.SLNB group can reduce the number of postoperative complications Moderate complications（OR=0.25,95%CI=[0.09,0.68],P=0.007）,the difference was statistically significant;11.SLNB group could reduce complications within 30 days after operation（OR=0.35,95%CI）=[0.13,0.92],P=0.03),the difference was statistically significant;12.The detection rate of positive pelvic lymph nodes in the SLNB group was higher than that in the PLND group（OR=1.90,95%CI=[1.06,3.40],P=0.03）,the difference was statistically significant;13.For the observation index of positive lymph node detection rate next to the abdominal aorta,the SLNB group was lower,（OR=0.29,95%CI=[0.06,1.42],P <0.00001）,the difference was statistically significant;14.After the analysis of the 2-year progression-free survival rate,there was no significant difference between the groups（OR=0.97,95%CI=[0.69,1.35],P=0.85）;15.after analyzing the 2-year survival rate,there was no significant difference between the groups（OR=1.39,95%CI=[0.67,2.90],P=0.38）;16.When evaluating the operation time,MD=-94.63,95%CI =[-143.42,-45.84],P=0.0001,the difference was statistically significant;17.SLNB group could reduce intraoperative blood loss,MD=-95.36,95%CI=[-144.27,-46.46],P =0.0001,the difference was statistically significant.Conclusion:1.Under the premise of not affecting the survival rate,sentinel lymph node biopsy can reduce the incidence of intraoperative and postoperative complications,reduce the overall recurrence rate and local recurrence rate,shorten the operation time,and reduce the blood loss,and increase the detection rate of positive pelvic lymph nodes.2.In the future clinical diagnosis and treatment,sentinel lymph nodes are likely to replace systematic pelvic lymph node dissection and provide patients with a more personalized diagnosis and treatment plan.The final results are still based on a large number of clinical trials and long follow-up work.