METHODS: A comprehensive search was conducted, including MEDLINE/Pubmed, EMBASE, and SCOPUS, through April 2023. Case series, cohort studies, and case-control studies of AST patients were eligible for inclusion. PRISMA guidelines were followed.
RESULTS: Twenty-two studies with a total of 756 AST patients were included. The pooled SNB prevalence was 54% (95% CI 32 to 75%), with substantial heterogeneity (I2 90%). The pooled SNB+ prevalence was 35% (95% CI 25 to 46%) with moderate heterogeneity (I2 39%). Lymphadenectomy was performed in 0-100% of SNB+ patients. Overall survival rates ranged from 93% to 100%, and disease-free survival ranged from 87% to 100% in AST patients. Overall and disease-free survival rates were 100% in SNB patients. Pooled survival estimates were not calculated due to the heterogeneous timing of the survival assessment and/or the small size of the subgroups. All studies clearly reported inclusion criteria and measured the condition in a standard way for all participants, but only 50% indicated valid methods for the identification of the condition.
CONCLUSIONS: The oncologic behavior of AST is related to an almost always favorable outcome. SNB does not seem to be relevant as a staging or prognostic procedure, and its indication remains debatable and controversial.
方法:进行了全面搜索,包括MEDLINE/Pubmed,EMBASE,和Scopus,到2023年4月。案例系列,队列研究,AST患者的病例对照研究符合纳入条件.遵循PRISMA指南。
结果:纳入了22项研究,共756例AST患者。汇总的SNB患病率为54%(95%CI32至75%),具有实质性异质性(I290%)。合并的SNB+患病率为35%(95%CI25-46%),具有中度异质性(I239%)。在0-100%的SNB患者中进行了淋巴结切除术。总生存率从93%到100%,AST患者的无病生存率为87%至100%.SNB患者的总体生存率和无病生存率为100%。由于生存评估的时间不均匀和/或亚组的规模小,未计算合并的生存估计值。所有研究都明确报告了纳入标准,并以标准方式衡量了所有参与者的病情。但只有50%的人指出了识别病情的有效方法。
结论:AST的肿瘤行为与几乎总是有利的结果有关。SNB似乎与分期或预后程序无关,其迹象仍有争议和争议。