Evidence map›Paper›PMID 37249632›Full record

SynthesisWorld journal of surgery2023

Can Axillary Lymph Node Dissection be Omitted in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes Undergoing Mastectomy? A Systematic Review and Meta-Analysis of Real-World Evidence.

Fulong Chen, Xiaowen Li, Xianjun Lin, Lijia Chen, Zhaoling Lin, Hao Wu, Jishang Chen

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 17% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Fulong ChenDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China.
Xiaowen LiDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China.
Xianjun LinDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China.
Lijia ChenDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China.
Zhaoling LinDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China.
Hao WuDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China.
Jishang ChenDepartment of Breast Surgery, Yangjiang People's Hospital (Affiliated Yangjiang Hospital of Guangdong Medical University), No. 42 of Dongshan Road, Jiangcheng District, Yangjiang, 529500, China. cjs2323@163.com.
Guangdong Medical College · CNQujiang People's Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe omission of axillary lymph node dissection (ALND) in patients with breast cancer who have metastatic sentinel lymph nodes (SLNs) undergoing mastectomy remains controversial. This meta-analysis explored the clinicopathological factors affecting the selection of ALND and the influences of ALND on survival outcomes in patients receiving mastectomy with positive SLNs.

methodsEligible studies published prior to 31 December 2022 were selected by searching the Embase, Web of Science and PubMed databases. Pooled analyses were performed using the number of events for clinicopathological parameters and HRs with 95% CIs for survival outcomes including disease-free survival (DFS), overall survival (OS), distant recurrence-free survival (DRFS) and locoregional recurrence-free survival (LRFS).

resultsA total of 10 retrospective studies enrolling only breast cancer patients with limited SLN metastases (no more than 3 positive SLNs or micrometastatic SLNs) undergoing mastectomy were included. Performing ALND in mastectomy patients who had limited SLN metastases was significantly correlated with invasive ductal carcinomas, larger tumors, lymphovascular invasion, higher tumor grade, macrometastatic SLNs, more positive SLNs, extranodal extension, positive surgical margins, negative ER, administration of adjuvant chemotherapy and nonwhite race (P < 0.05). However, performing ALND did not result in significantly longer OS, DFS, LRFS or DRFS (P > 0.05) in these patients.

conclusionThe present meta-analysis indicated that ALND may be safely avoided in patients with breast cancer who had limited SLN metastases undergoing mastectomy. Further well-designed randomized clinical trials are warranted to validate our results.

Indexed as

Breast NeoplasmsSentinel Lymph NodeAxillaFemaleHumansLymphatic MetastasisLymph Node ExcisionMastectomyRetrospective StudiesSentinel Lymph Node Biopsy

Identifiers

PMID37249632
OpenAlexW4378745349

What OpenQuestion holds

Textmetadata
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.