Original Title: Evaluación de la efectividad de la detección intraoperatoria del ganglio centinela en tumores sólidos

Authors' objectives: Assess the effectiveness and reliability of the intraoperative detection of the sentry ganglion, and the extirpation or otherwise of the ganglion in accordance with the test results, in the treatment of tumours of the breast, vulva and penis as well as of melanomas.

Authors' results and conclusions: With regard to health results, the bibliographical search failed to reveal any randomised clinical test that compares the relevant clinical results (survival, disease-free survival, recurrence of cancer, metastasis, complications of tests and surgeries, quality of life and aesthetic aspects), for radical lymphadenectomies as the first option, the sentry ganglion technique option and radical ganglion resections according to test results. It was seen that there are several randomised clinical tests underway, but their results will not be known for several years.

Authors' recommendations: In localised breast cancer, compared to the axillary lymphadenectomy option, which is currently the most habitual practice in our health services, the technical efficacy of the sentry ganglion technique is of an acceptable level for the detection of ganglion metastasis. This seems to be a reliable technique with regard to its repercussions on the survival of affected women and to the reoccurrence rate, in view of the fact that today, the immense majority of women with localised breast cancer are treated with a systemic treatment, be this with chemotherapy or tamoxifen. Compared to the axillary lymphadenectomy option, the sentry ganglion technique involves less risk of secondary effects. With regard to localised melanoma, for those health services that do not carry out routine regional lymphadenectomies, the sentry ganglion technique may be used to detect ganglion tumour alteration, which would benefit from a regional lymphadenectomy, in view of the fact that there are no systemic melanoma treatments of proven effectiveness. In those health services that perform routine regional lymphadenectomies, the sentry ganglion technique may be used to avoid unnecessary lymphadenectomies and also to detect unexpected drainage or ganglions in transit. In localised cancers of the vulva and localised cancers of the penis, the technique appears to the quite reliable, and seems to represent, therefore, a promising technique capable of avoiding a large number of unnecessary radical lymphadenectomies.

Authors' methods: Systematic review of the scientific literature on the effectiveness and reliability of the sentry ganglion technique. The bibliographical search was completed on December 6 2002 and was made in the following computerised databases: PubMed , Cancerlit, Cochrane Library, the Centre for Reviews and Dissemination of the University of York and the Spanish Medical Index. The most relevant characteristics of these studies are presented in a number of tables and a meta-analysis has been made of the different studies with the Meta-Test programme. In the case of breast cancer, an analysis was made of the possible clinical repercussions of the technique for a number of different prevalence situations of axillary alteration.

Project Status: Completed

Year Published: 2006

URL for published report: hhttps://www.euskadi.eus/contenidos/informacion/2006_osteba_publicacion/es_def/adjuntos/2006/d_06-01_ganglio_centinela.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Basque Office for Health Technology Assessment, Health Department Basque Government (OSTEBA)</p>