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BioMed Research International
Volume 2014, Article ID 489536, 9 pages
http://dx.doi.org/10.1155/2014/489536
Review Article

Prognostic Significance of Sentinel Lymph Node Mapping in Merkel Cell Carcinoma: Systematic Review and Meta-Analysis of Prognostic Studies

1Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9176699199, Iran
2Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad 9137913316, Iran
3Research Institute for Nuclear Medicine, Tehran University of Medical Sciences, Tehran 1411713137, Iran
4Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Via Ospedale 12, 6500 Bellinzona, Switzerland

Received 28 February 2014; Accepted 13 May 2014; Published 26 May 2014

Academic Editor: Rei Shibata

Copyright © 2014 Ramin Sadeghi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To assess through a systematic review and meta-analysis of the literature the prognostic implication of sentinel lymph node mapping in Merkel cell carcinoma (MCC). Materials and Methods. PubMed and SCOPUS databases were searched by using “Merkel AND sentinel” as keywords. All studies with prognostic information regarding SLN mapping in cN0 MCC patients were included. Hazard ratio (HR) for overall survival (OS) and disease free survival (DFS) was used as effect size. Results. SLN biopsy predicted better DFS and OS as compared to the nodal observation in cN0 MCC patients (pooled HR for DFS: 1.61 (95% CI: 1.05–2.46), ; pooled HR for OS: 1.08 (95% CI: 0.55–2.10), ). Pathologically negative SLN (SLN−) patients had better OS (pooled HR: 4.42 (95% CI: 1.82–10.7), ) and DFS (pooled HR: 2.58 (95% CI: 1.78–3.73)) as compared to SLN+ patients. Conclusion. SLN mapping can provide strong prognostic information regarding OS and DFS in cN0 MCC patients. More importantly, SLN mapping can improve DFS and possibly OS in cN0 MCC patients as compared to nodal observation. As MCC is a rare tumor, large multicenter prospective studies are still needed to validate the survival benefit of SLN mapping.