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Table 1 Diagnostic accuracy of tests to determine lymph node metatasis in primary endometrial cancer: study characteristics

From: A systematic review of tests for lymph node status in primary endometrial cancer

Author and Index Test Year Population Setting Index test and failure rate Reference Standard Histological method
SN      
Burke TW 1996 15 women recruited 15 women had index test and reference standard Stage: not stated Pelvic and paraaortic selective lymphadenectomy Open surgery Hospital – Not stated Country – USA Dates – not stated SN biopsy using 3 mls blue dye injected into subserosal myometrium 1 women unable to identify SN, positive lymph node status Histological method not stated
Echt M 1999 8 women recruited 8 women had index test and 7 reference standard Advanced disease prevented lymphadenectomy Stage:IB Pelvic and paraaortic lymphadenectomy Open surgery Hospital – Alton Ochsner Medical Foundation and University of South Florida Collage of Medicine Dates – 01/01/1993 – 31/03/1995 SN biopsy using 2 mls blue dye injected into uterine funds In all 7 women unable to identify SN, 1 women positive histology Histological method not stated
Holub Z 2001 8 women recruited 8 women had index test and reference standard Stage:IA-1, IB-5, IC-1, IIIC-1 Pelvic lymphadenectomy Laparoscopic surgery Hospital – Not stated Country – Czech Republic Dates – 01/200 – 11/2000 SN biopsy using 2 mls blue dye injected into subserosal myometrium 3 women unable to identify SN, all women histology negative Histological method not stated
Niikura H 2003 28 women recruited 28 women had index test and reference standard Stage: IA-7, IB-11, IIA-2, IIB-1, IIIA-1, IIIC-2 Pelvic and paraaortic lymphadenectomy Open surgery Hospital – Tohoku University School of Medicine Country – Japan Dates – 06/01 – 01/03 SN biopsy using 70 MBq technetium-99 m colloidal albumin injected hysteroscopically into endomertium 5 women unable to identify a SN, 1 women positive histology H and E staining and mmunohistochemistry
Pelosi E 2003 16 women recruited 16 women had index test and reference standard Stage: Ib-16 Pelvic lymphadenectomy Laparoscopic surgery Hospital – Not stated Country – Italy Dates – 02/02 – 04/02 SN biopsy using 37 MBq technetium-99 m colloidal albumin and 4 ml blue dye injected into the cervix 1 women unable to identify SN, negative lymph node status H and E staining and immunohistochemistry
Raspagliesi F 2003 18 women recruited18 women had index test14 women had reference standard4 excluded, 2 due to disease stageStage IA-4, IB-9, IIIA-1, IIIC-4Pelvic lymphadenectomy in all women, paraaortic only if deemed necessaryOpen surgery Hospital – Not statedCountry – ItalyDates – Not stated SN biopsy using 111 MBq technetium-99 m colloidal albumin injected hysteroscopically into sub endomertium H and E staining
Fersis N 2003 10 Women recruited 10 women had index test and reference standard Stage : Ib pelvic +/- paraaortic lymphadenectomy Open surgery Hospital – Not stated Country – Germany Dates – Not stated SN biopsy using 40–100 MBq technetium-99 m colloidal albumin injected hysteroscopically into tumour 3 patients unable to identify SN, patient's lymph node status was negative Histological method not stated
Holub Z 2004 25 women recruited 25 women had index test and reference standard Stage: not stated Pelvic lymphadenectomy (yes patent had sampling only) Laparoscopic surgery Hospital – Not stated Country – Czech Republic Dates – 02/00 – 08/03 SN using 5 ml blue dye injected into cervix and uterine fundus 4 patients unable to identify SN, patients lymph node status was negative Histological method not stated
Lelievre L 2004 12 women recruited 12 women had index test and reference standard Stage: Ib-2, Ic-5, IIa-1, IIb-1, IIIc-3 Pelvic lymphadenectomy Laparoscopic surgery Hospital – Not stated Country – France Dates 01/02 – 12/02 SN biopsy using 120 MBq technetium-99 m colloidal albumin injected in to the cervix and 2 mls blue dye injected into the cervix 11 patients had SN identified using combined technique, 10 using technetium-99 m alone and 9 using blue dye alone H and E staining and immunohistochemistry
CT      
Balfe DM 1983 61 women recruited 18 women had index test and reference standard 43 women excluded without explanation Stage: not stated Pelvic and paraaortic lymphadenectomy Open surgery Hospital – Mallinckrodt Institute of Radiology Country – USA Dates – 07/76 – 07/81 CT using EMI CT500S and EMI 7070 3s scanners Lymph nodes > 10 mm abnormal Histological method not stated
Varpula MJ 1993 47 women recruited47 women had index test43 women had index test and reference standard, 4 women excluded as suitable for dxt onlyStage: I-36, II-7Pelvic and paraaortic unilateral and bilateral clearance and samplingOpen surgery Hospital – Not statedCountry – FinlandDates – 05/87 – 05/90 CT scan using Siemans Somatom CR/General Electric 9800 scannerslymph nodes > 10 mm abnormal Histological method not stated
La Fianza A 1997 125 women recruited 125 women index test and reference standard Stage: I-125, II-12, III-8 Pelvic lymphadenectomy Open surgery Hospital – Not stated Country – Italy Dates – 01/1996 – 09/1993 CT using III generation Somatom 2, Somatome Plus and Siemens scanner Histological method not stated
Conner JP 2000 702 women were eligible, 210 excluded follow up at another centre, secondary malignancy or no surgery planned 487 women excluded as no CT 75 women had index test 56 women had reference standard, 6 had no lymphadenectomy due to index test results, 13 no explanation Stage : I-350, II-73, III-49, IV-20 Pelvic and paraaortic lymph node sampling Open surgery Hospital – University of Iowa Hospital and Clinics Country – USA Dates – 1979 – 1993 CT scanner model not stated Histological method not stated
Zerbe M 2000 54 women recruited 54 women index test 36 women reference standard, no explanation for exclusion Stage I–III Lymph node type not stated Surgery type not stated Hospital – Baltimore Medical Centre Country – USA Dates – 01/90 – 12/98 CT scanner model not stated No definition for lymph node abnormality Histological method not stated
USS      
Sawicki W 2003 90 women recruited90 women had index test and reference standardStage – not statedlymph node type not statedSurgery type, not stated Hospital – Not statedCountry – PolandDates – Not stated USS either abdominal or transvaginal using Siemens Sonoline Versu Prox with a 6.5–7.5 MHZ probe for transvaginal and 3.5 MHZ probe for abdominal definition for lymph node abnormality Histological method not stated
MRI      
Hricak H 1991 20 women recruited 20 women had the index test and reference standard Stage: I-16, II-1, III-3 Pelvic lymph node sampling Open surgery Hospital – Not stated Country – USA Dates – 01/02/89 – 01/12/89 MRI using 1.5T Sigma and 1.5T Magnetom scanner lymph nodes > 10 mm abnormal Histological method not stated
Varpula MJ 1993 46 women recruited 46 women had index test 43 women had the index test and reference standard, 3 excluded as suitable for DXT only Stage: I-36, II-7 Pelvic and paraaortic unilateral and bilateral clearance and sampling Open surgery Hospital – Not stated Country – Finland Dates – 05/87 – 05/90 MRI using < 0.05T Acut scanner Lymph nodes > 10 mm abnormal Histological method not stated
Taieb S 2002 86 women recruited 86 women had index test and reference standard Stage: Ia-24, Ib-26, Ic-14, IIa-2, Iib-2, IIIc-15, IVa-2, IVb-1 Pelvic and paraaortic lymphadenectomy Open surgery Hospital – Not stated Country – France Dates – 01/97 – 03/02 MRI scanner type not stated Histological method not stated
Manfredi R 2004 37 women recruited 37 women had index test 21 women had reference standard, 16 women excluded as no lymph nodes were palpable Stage: Ia-2, Ib-20, Ic-15 Pelvic lymph node sampling in 11, pelvic and paraaortic lymphadenectomy in 10 Open surgery Hospital – Not stated Country – Italy Dates – 06/97 – 02-01 MRI using 1.5T Echospeed, GE medical System scanner Lymph nodes abnormal > 10 mm Histological method not stated
  1. SN = sentinel node MRI = magnetic resonance imaging H and E staining = hematoxylin and eosin staining. CT = computer tomography USS = ultrasound scan.