Hertfordshire and Bedfordshire Urological Cancer Centre, Lister Hospital, Stevenage SG1 4AB, UK.
S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Curr Oncol. 2022 Feb 23;29(3):1335-1348. doi: 10.3390/curroncol29030114.
Detection of lymph node status in bladder cancer significantly impacts clinical decisions regarding its management. There is a wide range of detection modalities for this task, including lymphoscintigraphy, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, positron emission tomography, and fluoroscopy. We aimed to study the pre- and intraoperative detection modalities of sentinel lymph nodes in urinary bladder cancer.
This narrative review was performed by searching the PubMed and EMBASE libraries using the following search terms: ("Transitional cell carcinoma of the bladder" OR "urothelial cancer" OR "urinary bladder cancer" OR "bladder cancer") AND (("sentinel lymph node") OR ("lymphatic mapping") OR ("lymphoscintigraphy") OR ("lymphangiography") OR ("lymph node metastases")). Studies analysing the effectiveness and outcomes of sentinel lymph node detection in bladder cancer were included, while non-English language, duplicates, and non-article studies were excluded. After analysing the libraries and a further manual search of bibliographies, 31 studies were included in this paper. We followed the RAMESES publication standard for narrative reviews to produce this paper.
Of the 31 studies included, 7 studies included multiple detection methods; 5 studies included lymphoscintigraphy; 5 studies included computed tomography and/or single-photon emission computed tomography; 5 studies included fluoroscopy; 4 studies included magnetic resonance imaging; and 5 studies included positron emission tomography.
Anatomical, radioactive, and functional detection modalities have been studied independently and in combination. The consensus is that preoperative detection with imaging helps guide surgical management and intraoperative detection methods help capture any lymph nodes that may have been missed. Each of these types of detection represent their own set of benefits and drawbacks, but there is currently limited evidence to support any change in overall practice to replace conventional staging.
膀胱癌淋巴结状态的检测对其治疗管理的临床决策有重大影响。目前有多种检测方法可用于此任务，包括淋巴闪烁显像、计算机断层扫描、磁共振成像、单光子发射计算机断层扫描、正电子发射断层扫描和荧光透视。我们旨在研究膀胱癌中前哨淋巴结的术前和术中检测方法。
通过在 PubMed 和 EMBASE 库中使用以下搜索词进行叙述性综述：（“膀胱移行细胞癌”或“尿路上皮癌”或“膀胱癌”或“膀胱癌”）和（“前哨淋巴结”或“淋巴作图”或“淋巴闪烁显像”或“淋巴管造影”或“淋巴结转移”）。包括分析前哨淋巴结检测在膀胱癌中的有效性和结果的研究，而排除非英语语言、重复和非文章研究。在分析了这些文库并进一步手动搜索参考文献后，本文纳入了 31 项研究。我们遵循叙述性综述的 RAMESES 出版标准来撰写本文。
在纳入的 31 项研究中，有 7 项研究包括多种检测方法；5 项研究包括淋巴闪烁显像；5 项研究包括计算机断层扫描和/或单光子发射计算机断层扫描；5 项研究包括荧光透视；4 项研究包括磁共振成像；和 5 项研究包括正电子发射断层扫描。
已经独立和联合研究了解剖学、放射性和功能性检测方法。共识是术前使用成像进行检测有助于指导手术管理，而术中检测方法有助于捕获任何可能遗漏的淋巴结。这些检测类型中的每一种都有其自身的优缺点，但目前尚无证据支持任何改变常规分期的总体实践。
