Sentinel lymph node biopsy in ovarian cancer: More questions than certainties

In this month’s Lead Article, Agustí and colleagues describe their systematic review and meta- analysis aimed at evaluating the detection rate and diagnostic accuracy of sentinel lymph node biopsy mapping in patients with early stage ovarian cancer.1 The study showed a 92% pooled detection rate and 100% nega tive predictive value of sentinel lymph node biopsy. In particular, the dual tracers, technetium- 99 and indo cyanine green, and dual site injection (utero- ovarian and infundibolo- pelvic ligament), gave optimal detec tion when injected before adnexectomy. The paper will represent a reference for future studies with well defined protocols. Regrettably, as the authors high lighted, small sample size, period of inclusion of the studies, and substantial clinical and technical hetero geneity prevented robust conclusions on the accuracy of sentinel lymph node biopsy in this population.