Evidence map›Paper›PMID 28403815›Full record

Observational studyBMC cancer2017

Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol.

Charlotte M C Oude Ophuis, Lisa B Koppert, Cécile de Monyé, Carolien H M van Deurzen, Senada Koljenović, Alexander C J van Akkooi, Cornelis Verhoef, Dirk J Grünhagen

Erratum issuedOpen access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMC cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Review
  3. Can integrated 18F-FDG PET/MR replace sentinel lymph node resection in malignant melanoma?European journal of nuclear medicine and molecular imaging · 2018
    Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Charlotte M C Oude OphuisDepartment of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075, Rotterdam, EA, The Netherlands. c.oudeophuis@erasmusmc.nl.
Lisa B KoppertDepartment of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075, Rotterdam, EA, The Netherlands.
Cécile de MonyéDepartment of Radiology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075, Rotterdam, EA, The Netherlands.
Carolien H M van DeurzenDepartment of Pathology, Erasmus Medical Center, Wytemaweg 80, 3015, Rotterdam, CN, The Netherlands.
Senada KoljenovićDepartment of Pathology, Erasmus Medical Center, Wytemaweg 80, 3015, Rotterdam, CN, The Netherlands.
Alexander C J van AkkooiDepartment of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066, Amsterdam, CX, The Netherlands.
Cornelis VerhoefDepartment of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075, Rotterdam, EA, The Netherlands.
Dirk J GrünhagenDepartment of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075, Rotterdam, EA, The Netherlands.
Erasmus MC Cancer Institute · NLErasmus MC · NLThe Netherlands Cancer Institute · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSentinel node (SN) biopsy (SNB) detects clinically occult metastases of breast cancer and melanoma in 20-30%. Wound infections, seroma and lymph edema occur in up to 10%. Targeted ultrasound (US) of the SN, (with fine needle aspiration cytology (FNAC) if appropriate) has been investigated as a minimally invasive alternative, but reported sensitivity rates are too low to replace SNB. Our hypothesis is that the use of a handheld gamma probe concomitant with US may improve sensitivity. Our aim is to provide an overview of the current literature on preoperative nodal staging of clinical N0 melanoma patients, report on a pilot, and present a study protocol for a minimally invasive alternative to the SNB: Gamma probe and Ultrasound guided Fine needle aspiration cytology of the sentinel node (GULF trial).

methodsThe GULF trial is a multicenter open single arm observational trial. Newly diagnosed cT1b-4N0M0 cutaneous melanoma or cT1-3N0M0 breast cancer patients, aged >18 years, presenting for SNB are eligible. 120 patients will be included for preoperative targeted gamma probe guided US and FNAC of the SN. Afterwards all patients proceed to surgical SNB. Primary endpoint is the sensitivity of FNAC. Secondary endpoints include SN identification rate and the histopathological compatibility of Core Needle Biopsy and FNAC vs. SNB. Secondary endpoints were investigated in a pilot with 10 FNACs and marker placements, and 10 FNACs combined with Core Needle Biopsy.

resultsA pilot in 20 patients showed that SN identification rate was 90%, supporting the feasibility of this technique. DISCUSSION: There is broad experience with US (in combination with FNAC) prior to SNB, but sensitivity and specificity are too low to completely abandon SNB. Promising alternative techniques potentially will replace SNB in the future but more evidence is needed in the form of prospective studies. Accurate identification of the SN for US-FNAC has been proven feasible in our pilot. When adequate sensitivity can be reached, US-FNAC provides a minimally invasive alternative for the surgical SNB procedure.

trial registrationThe GULF trial is registered in the Netherlands Trial Registry (NTR), ID: NRT5193 . May 1st 2015.

Indexed as

Breast NeoplasmsEndoscopic Ultrasound-Guided Fine Needle AspirationMelanomaSentinel Lymph Node BiopsySkin NeoplasmsFeasibility StudiesFemaleGamma RaysHumansLymphatic MetastasisMaleNeoplasm StagingPilot ProjectsProspective StudiesSensitivity and SpecificityBreast NeoplasmsFine-needle biopsyMelanomaMinimally invasive surgical proceduresSentinel lymph node biopsyUltrasonography

Identifiers

PMID28403815
PMCPMC5389093
OpenAlexW3041298557

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.