Critical appraisal:Andreou D, Boldt H, Werner M, Hamann C, Pink D, Tunn PU 2013

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Critical Appraisal

Article being appraised

Andreou D, Boldt H, Werner M, Hamann C, Pink D, Tunn PU. Sentinel node biopsy in soft tissue sarcoma subtypes with a high propensity for regional lymphatic spread--results of a large prospective trial. Ann Oncol 2013 May;24(5):1400-5 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23372051.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

62


Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Large study of mixed paed/adult group (age range 6-73yrs), 62 patients with sarcomas having SNBx. 2/42 Synovial, 6/12 clear cell, 0/4 epithelioid and 0/4 RMS had positive SNBx. 2 patients with negative SNBx went on to have LN mets within 12/12 later. Also several patients had systemic spread after negative SNBx.

Side effects/comps: wound infection/heal delay 2/62, lymph fistula 1/62. Suggests SNBx useful in clear cell arc, not in synovial. Prognosis after negative SNBx much better than after positive SNBx (84% vs 60% 2yr survival, 74% vs 40% 5 yr survival).

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
Yes
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
2 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
1 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Roger Woods MBBS, FRACS


Jutta's tick icon.png This appraisal has been completed.


Article
Andreou D, Boldt H, Werner M, Hamann C, Pink D, Tunn PU. Sentinel node biopsy in soft tissue sarcoma subtypes with a high propensity for regional lymphatic spread--results of a large prospective trial. Ann Oncol 2013 May;24(5):1400-5 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23372051.
Assigned to
User:Roger.woods
Topic area
Guidelines:Guidelines:Sarcoma/AYA/Sentinel lymph nose biopsy
Clinical question
Form
Form:Critical appraisal


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