Department of Urology, ABC Medical School, Santo Andre, Brazil.
Ann Surg Oncol. 2011 Jul;18(7):2026-34. doi: 10.1245/s10434-010-1546-6. Epub 2011 Feb 10.
Dynamic sentinel node biopsy (DSNB) is used to evaluate the nodal status of patients with clinically node-negative penile carcinoma. Its use is not widespread, and the majority of patients with clinically node-negative disease undergo an elective inguinal lymph node dissection (ILND). However, a prophylactic bilateral ILND is a procedure with approximately 50% of morbidity. The purpose of this review is to evaluate the accuracy of DSNB in penile cancer.
This is a systematic review and cumulative analysis of studies published between 1966 and 2010. The Medline, Embase, Cancerlit, and American Society of Clinical Oncology abstract databases were searched for published studies on penile cancer and DSNB. The outcomes assessed were: sensitivity, specificity, likelihood ratios, and summary receiver operating characteristics (ROC) curves.
Ten articles covering 519 participants were included in the cumulative analysis. The pooled sensitivities and specificities for sentinel node biopsy for detection of metastasis were 77.1 and 100% versus ILND and 87.9 and 100% versus wait and see program. The false-negative rate founded was 3.1% in the ILND group and 3.5% in the wait and see group.
The use of dynamic sentinel lymph node biopsy to detect lymph node metastasis in specialized centers appears to be justified. Addiction of other techniques to DSNB to reduce false-negative results is awaited and must be confirmed by future studies.
动态前哨淋巴结活检（DSNB）用于评估临床淋巴结阴性阴茎癌患者的淋巴结状态。其应用并不广泛，大多数临床淋巴结阴性的患者接受选择性腹股沟淋巴结清扫术（ILND）。然而，预防性双侧 ILND 的发病率约为 50%。本综述的目的是评估 DSNB 在阴茎癌中的准确性。
这是一项对 1966 年至 2010 年发表的研究进行的系统回顾和累积分析。检索 Medline、Embase、Cancerlit 和美国临床肿瘤学会摘要数据库中关于阴茎癌和 DSNB 的已发表研究。评估的结果是：敏感性、特异性、似然比和汇总受试者工作特征（ROC）曲线。
10 篇涵盖 519 名参与者的文章被纳入累积分析。用于检测转移的前哨淋巴结活检的汇总敏感性和特异性分别为 77.1%和 100%，与 ILND 相比为 87.9%和 100%，与等待观察方案相比。在 ILND 组和等待观察组中发现的假阴性率分别为 3.1%和 3.5%。
在专门中心使用动态前哨淋巴结活检来检测淋巴结转移似乎是合理的。添加其他技术来减少假阴性结果有待进一步研究证实。
