Acta OncologicaPub Date : 2026-04-17DOI: 10.2340/ao.v65.45596
Eugenio Ventimiglia, Hans Garmo, Rolf Gedeborg, Mats Ahlberg, Armando Galdieri, Andri Wilberg Orrason, Lars Holmberg, Pär Stattin, David Robinson
{"title":"Extent of prostate cancer cases not registered in The National Cancer Register of Sweden and consequences for estimates of prostate cancer incidence and mortality.","authors":"Eugenio Ventimiglia, Hans Garmo, Rolf Gedeborg, Mats Ahlberg, Armando Galdieri, Andri Wilberg Orrason, Lars Holmberg, Pär Stattin, David Robinson","doi":"10.2340/ao.v65.45596","DOIUrl":"10.2340/ao.v65.45596","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"297-300"},"PeriodicalIF":2.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-04-15DOI: 10.2340/ao.v65.45593
Armando Galdieri, Hans Garmo, Rolf Gedeborg, Mats Ahlberg, Andri Wilberg Orrason, Eugenio Ventimiglia, Pär Stattin, Marcus Westerberg
{"title":"Temporal trends in diagnostic work-up, treatment, and mortality in locally advanced prostate cancer in 2016-2024: nationwide, population-based study in Sweden.","authors":"Armando Galdieri, Hans Garmo, Rolf Gedeborg, Mats Ahlberg, Andri Wilberg Orrason, Eugenio Ventimiglia, Pär Stattin, Marcus Westerberg","doi":"10.2340/ao.v65.45593","DOIUrl":"10.2340/ao.v65.45593","url":null,"abstract":"<p><strong>Background and purpose: </strong>We aimed to describe temporal changes in diagnostic work-up, treatment, and prostate cancer (PCa) mortality in locally advanced PCa in 2016-2024 in Sweden. Patient/material and methods: Men registered in the National Prostate Cancer Register of Sweden in 2016-2024 with locally advanced PCa; clinical T stage 3-4, no distant metastases, and prostate-specific antigen < 100 ng/ml were included. We computed the proportion of use of prostate magnetic resonance imaging (MRI) before biopsy, radical prostatectomy, radical radiotherapy, androgen deprivation therapy, and abiraterone, and described the trend in PCa mortality across three calendar periods.</p><p><strong>Results: </strong>During the 9-year study period 7,484 men with locally advanced PCa were identified. Use of MRI before biopsy increased from 3% in 2016 to 73% in 2024. Concomitantly, radical treatment increased from 35% to 48%, entirely due to increased use of radiotherapy. Abiraterone was not used before 2022 but 31% received this treatment in 2024. The 3-year PCa mortality decreased from 8% (95% confidence interval [CI]: 7-9) in 2016-2018 to 6% (95% CI: 4-8) in 2022-2024.</p><p><strong>Interpretation: </strong>In this nationwide, population-based study of men with locally advanced PCa, the use of MRI before biopsy, radical radiotherapy, and treatment with abiraterone increased over time. These changes coincided with a modest decrease in 3-year PCa mortality.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"282-288"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-04-13DOI: 10.2340/ao.v65.45355
Edvard Abel, Päivi Östling, Ebba Hallersjö Hult, Katarzyna Kulbacka, Haris Babacic, Annika Baan, Ana Carneiro, Luigi De Petris, Henrik Fagman, Signe Friesland, Oskar Frisell, Mats Hellström, Gabriel Lindahl, Katarina Steen Carlsson, David Tamborero, Antonios Valachis, Daniel Öhlund, Janne Lehtiö, Richard Rosenquist, Anders Edsjö
{"title":"FOCU.SE trial: a nationwide Swedish drug repurposing protocol and research framework.","authors":"Edvard Abel, Päivi Östling, Ebba Hallersjö Hult, Katarzyna Kulbacka, Haris Babacic, Annika Baan, Ana Carneiro, Luigi De Petris, Henrik Fagman, Signe Friesland, Oskar Frisell, Mats Hellström, Gabriel Lindahl, Katarina Steen Carlsson, David Tamborero, Antonios Valachis, Daniel Öhlund, Janne Lehtiö, Richard Rosenquist, Anders Edsjö","doi":"10.2340/ao.v65.45355","DOIUrl":"10.2340/ao.v65.45355","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-04-13DOI: 10.2340/ao.v65.45500
Annbjørg H Søreide, Karin H Edland, Andreas B Alvestad, Solveig Hodne, Kjetil Søreide
{"title":"Malpractice claims for pancreatic cancer in Norway: claim-rates, injury domains, claim outcomes and indemnity compensation.","authors":"Annbjørg H Søreide, Karin H Edland, Andreas B Alvestad, Solveig Hodne, Kjetil Søreide","doi":"10.2340/ao.v65.45500","DOIUrl":"10.2340/ao.v65.45500","url":null,"abstract":"<p><strong>Background and purpose: </strong>Pancreatic cancer is difficult to diagnose early and at a curative stage, yet little is known about errors in management. The aim of the study was to investigate malpractice claims in Norway.</p><p><strong>Patients and methods: </strong>All malpractice claims filed to the Norwegian System of Patient Injury Compensation between 2015 and 2024 for pancreatic cancer were evaluated.</p><p><strong>Results: </strong>A total of 148 claims (median 15 [range 8-20] claims/year) were filed among 9548 patients with pancreatic cancer, for an average claim rate of 1.55% (1 claim per every 65 pancreatic cancers). Most claims were filed against hospital/specialists (n = 90), followed by general practitioners (n = 49) with nine claims towards private practice contractors (P < 0.001). A total of 33 claims (22.3%) were approved, of which 28 (85%) concerned delayed diagnosis. Radiology was involved in 18 of the 33 approvals. According to caretaker-level for the malpractice claim, approved claims were 23% for hospital-claims, with lowest approval-rate against general practitioners (12%), and highest against private contractors (66%). Median delay in diagnosis was estimated at 6 months. The outcome of the error was 'death' in 16 of 33. Prognostic loss was determined in five of 33 patients, while 12 patients had no prognostic loss despite an approved claim. Caretaker-level did not differ regarding death or prognostic loss in claims (P = 0.203). A total of 1.47 million EUR was paid in indemnity payments.</p><p><strong>Interpretation: </strong>The claim rate of 1.5% was stable, with about one in five claims approved. Diagnostic delay was the predominant cause, with several stakeholders involved across the healthcare system.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"273-281"},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Targeted therapy in the treatment of lung cancer in Iceland 2010-2023.","authors":"Stefanía Ásta Tryggvadóttir, Guðlaugur V Stefánsson, Helgi Birgisson, Örvar Gunnarsson, Tómas Guðbjartsson, Hrönn Harðardóttir, Bylgja Hilmarsdóttir, Rósa B Barkardóttir, Sigurdis Haraldsdottir","doi":"10.2340/ao.v65.45118","DOIUrl":"10.2340/ao.v65.45118","url":null,"abstract":"<p><strong>Background and purpose: </strong>Lung cancer is the third most common malignancy in Iceland and remains the leading cause of cancer-related mortality. Lung cancer may harbor driver mutations affecting the function of Epidermal growth factor receptor (EGFR), Anaplastic lymphoma kinase (ALK), ROS proto-oncogene 1 (ROS1), B-raf proto-oncogene (BRAF), RET proto-oncogene (RET), MET proto-oncogene (MET), and NTRK, which can influence the selection of targeted therapies and treatment outcomes. In Iceland, EGFR testing was initiated in 2005, and in 2016, multigene targeted panel became standard for tumor testing. The objective was to determine the uptake of testing and frequency of targeted mutations in lung cancer nationwide, the utilization of targeted therapies, and duration of such treatments.</p><p><strong>Patients/material and methods: </strong>Data on lung cancer diagnoses and stage at diagnosis were obtained from the Icelandic Cancer Registry, and molecular testing results were retrieved from the Department of Pathology at Landspitali University Hospital. Treatment data and outcomes were obtained from a central prescription/death registry and chart reviews.</p><p><strong>Results: </strong>From 2010 to 2023, 2,528 patients were diagnosed with lung cancer, and 25% underwent -molecular tumor testing, with 90% of stage IV adenocarcinomas tested in 2023. During comprehensive molecular testing in 2016-2023, targeted mutations were detected in 19.3% of tested patients: EGFR 9.9%, BRAF 2.3%, MET 2.7%, HER2 1.2%, ALK 2.7%, ROS1 0.6%, and RET 0.2%. Among patients found to have targeted mutations (2010-2023), 61.2% received targeted therapy; 33.8% remained on therapy for ≥ 12 months, and 13.5% for ≥ 24 months.</p><p><strong>Interpretation: </strong>The use of molecular testing has increased significantly in the last 20 years, and the -adaptation of new targeted therapies has been rapid.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"261-267"},"PeriodicalIF":2.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-04-01DOI: 10.2340/1651-226X.2026.44933
Yuhui Feng, Liushan Wei, Qinhong Zou, Xiaoyong Lei, Xiaoyan Yang
{"title":"Prevalence and risk factors for nausea and vomiting in breast cancer patients undergoing chemotherapy.","authors":"Yuhui Feng, Liushan Wei, Qinhong Zou, Xiaoyong Lei, Xiaoyan Yang","doi":"10.2340/1651-226X.2026.44933","DOIUrl":"10.2340/1651-226X.2026.44933","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chemotherapy-induced nausea and vomiting (CINV) is a common and severe adverse effect of breast cancer (BC) treatment that compromises treatment adherence and quality of life. This meta-analysis aims to assess the prevalence and risk factors of CINV in BC patients, thereby providing clinical insights for its prevention and improvement. Patient/material and methods: Relevant literature was identified through an extensive search of electronic databases from their inception up to July 10, 2025: PubMed, Web of Science, Embase, Cochrane, CNKI, Wanfang, and VIP databases on prevalence rates, odds ratios (OR), and corresponding 95% confidence intervals (CI) were extracted for analysis.</p><p><strong>Results: </strong>The screening process identified 12 eligible studies. The meta-analysis showed that the overall prevalence of CINV in BC patients was 48% (95% CI = 0.37-0.58). Univariate analysis identified the following risk factors: age ≤ 45 years (OR = 3.21, 95% CI = 1.44-7.17) and a history of motion sickness (OR = 4.85, 95% CI = 1.65-14.30). Multivariate analysis showed that age ≤ 45 years (OR = 2.36, 95% CI = 1.78-3.14), history of motion sickness (OR = 2.05, 95% CI = 1.42-2.98), and chemotherapy cycles ≥ 3 (OR = 2.27, 95% CI = 1.28-4.04) were risk factors. In contrast, anxiety (OR = 2.74, 95% CI = 0.66-11.29) and comorbidities (OR = 1.04, 95% CI = 0.72-1.49) were not significantly associated with CINV in BC patients.</p><p><strong>Interpretation: </strong>This meta-analysis shows that the prevalence of CINV in BC patients is high. It focused on the Asian population and indicated that younger age, history of motion sickness, and more chemotherapy cycles (≥ 3) were risk factors for CINV. Targeting these risk factors may help prevent CINV in BC patients.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"252-260"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-03-23DOI: 10.2340/1651-226X.2026.45030
Jenny Kahlmeter Brandell, Antonis Valachis, Henrik Ugge, Daniel Smith, Bengt Johansson
{"title":"Association between short-term radiation-induced toxicity and oncological outcomes in high-risk prostate cancer: a retrospective single-centre cohort study.","authors":"Jenny Kahlmeter Brandell, Antonis Valachis, Henrik Ugge, Daniel Smith, Bengt Johansson","doi":"10.2340/1651-226X.2026.45030","DOIUrl":"10.2340/1651-226X.2026.45030","url":null,"abstract":"<p><strong>Background and purpose: </strong>This retrospective cohort study aimed to explore the association between short-term genitourinary (GU) and gastrointestinal (GI) toxicity and oncological outcomes in high-risk prostate cancer patients treated with external beam radiotherapy (EBRT) alone or with high-dose-rate brachytherapy (HDR-BT). Patient/material and methods: High-risk prostate cancer patients treated at Örebro University Hospital (2008-2021) were divided into two cohorts based on treatment modality: EBRT-only (66 Gy/22 fractions), EBRT-BT (42 Gy/14 fractions + 14.5 Gy HDR-BT-boost). Maximum 6-month toxicity grade was categorised as: GU-low (grade 0-1), GU-high (grade ≥ 2), GI-low (grade 0) and GI-high (grade ≥ 1), respectively. Freedom from biochemical failure (FFBF), metastasis-free survival (MFS) and overall survival were compared between the low- and high- toxicity groups, using Kaplan-Meier and Cox proportional hazards regression. Prostate cancer-specific mortality was compared between the groups using the Aalen-Johansen method and Fine-Gray regression.</p><p><strong>Results: </strong>The EBRT-only cohort encompassed 114 and 162 patients for GU- and GI-analyses. The EBRT-BT cohort comprised 306 patients for GU- and 344 patients for GI-analyses. High GU-toxicity was associated with inferior FFBF (adjusted hazard ratio (aHR) = 2.57, 95% Confidence Interval [CI] = 1.32-5.00) and MFS (aHR = 2.22, 95% CI = 1.21-4.07) in the EBRT-only but not in the EBRT-BT cohort. No statistically significant associations were found between GI-toxicity and oncological outcomes.</p><p><strong>Interpretation: </strong>Early grade ≥ 2 GU-toxicity was linked to worse FFBR and MFS after EBRT alone, whereas no such association was seen after EBRT-BT. GI toxicity showed no prognostic impact. These exploratory findings warrant validation in larger studies addressing interactions between patient-, tumour- and treatment-related factors.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"241-251"},"PeriodicalIF":2.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13019436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-03-19DOI: 10.2340/1651-226X.2026.45040
Frigg Å Sommervoll, Henrik Horndalsveen, Dag Einar Sommervoll, Jussi Koivonen, Tarje Onsøien Halvorsen, Bjørn Henning Grønberg, Marianne Aanerud, Saulius Cicenas, Nina Helbekkmo, Jarkko Ahvonen, Maria Silvoniemi, Gina Barrera, Maria M Bjaanæs, Vilde Haakensen, Åsa Öjlert, Kersti Oselin, Åslaug Helland, Tesfaye Madebo
{"title":"How does pulmonary function impact QoL in patients with locally advanced NSCLC treated with chemoradiotherapy and durvalumab?","authors":"Frigg Å Sommervoll, Henrik Horndalsveen, Dag Einar Sommervoll, Jussi Koivonen, Tarje Onsøien Halvorsen, Bjørn Henning Grønberg, Marianne Aanerud, Saulius Cicenas, Nina Helbekkmo, Jarkko Ahvonen, Maria Silvoniemi, Gina Barrera, Maria M Bjaanæs, Vilde Haakensen, Åsa Öjlert, Kersti Oselin, Åslaug Helland, Tesfaye Madebo","doi":"10.2340/1651-226X.2026.45040","DOIUrl":"10.2340/1651-226X.2026.45040","url":null,"abstract":"<p><strong>Background: </strong>Impaired pulmonary function is common among patients with lung cancer and may negatively affect health-related quality of life (HRQoL). The primary objective of the present sub-study of the DART-trial was to assess the overall quality of life changes during treatment and stratified by the presence of Chronic Obstructive Pulmonary Disease (COPD).</p><p><strong>Methods: </strong>The investigator-initiated DART trial (NCT04392505) included patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with chemoradiotherapy followed by durvalumab. Baseline pulmonary function was measured by spirometry, and patients were stratified by FEV1/FVC <70% (COPD) or ≥70% (non-COPD). HRQoL was assessed regularly using the EORTC QLQ-C30 and QLQ-LC13 questionnaires at screening and during treatment. A difference in mean score of ≥10 was defined as clinically significant.</p><p><strong>Results: </strong>A total of 86 patients initiated durvalumab and completed at least one HRQoL assessment; pulmonary function data were available for 64 patients. For the overall cohort, quality of life scores remained stable throughout treatment. Patients with COPD consistently reported lower global health scores than those with preserved lung function. The global health score among patients with COPD was not significantly different at end of treatment compared to baseline, however significantly lower than patients without COPD. Symptom trajectories across QLQ-C30 scales were stable in both groups. Dyspnoea was more prevalent among patients with COPD. In the LC13 module, no clinically significant differences were observed except for dyspnoea, which was consistently higher among patients with COPD.</p><p><strong>Interpretation: </strong>The HRQoL remained stable during chemoradiotherapy and durvalumab treatment in stage III NSCLC patients. Impaired lung function was associated with modestly lower HRQoL, though larger studies are needed to confirm subgroup effects.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"232-240"},"PeriodicalIF":2.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-03-18DOI: 10.2340/1651-226X.2026.45489
Mef Nilbert, Gunnar Wagenius, Simon Ekman
{"title":"Feasibility of lung cancer screening in low-risk populations of the Nordic countries.","authors":"Mef Nilbert, Gunnar Wagenius, Simon Ekman","doi":"10.2340/1651-226X.2026.45489","DOIUrl":"10.2340/1651-226X.2026.45489","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"228-231"},"PeriodicalIF":2.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta OncologicaPub Date : 2026-03-16DOI: 10.2340/1651-226X.2026.44984
Chao He, Fei Li, Min He, Jia Li
{"title":"The false-negative rate of sentinel lymph node biopsy and its related factors in early-stage cervical cancer: a systematic review and meta-analysis.","authors":"Chao He, Fei Li, Min He, Jia Li","doi":"10.2340/1651-226X.2026.44984","DOIUrl":"10.2340/1651-226X.2026.44984","url":null,"abstract":"<p><strong>Background and purpose: </strong>The objective of this systematic review and meta-analysis was to evaluate the false-negative rate (FNR) of sentinel lymph node biopsy (SLNB) performed in patients with early-stage cervical cancer (ECC), and to study the risk factors affecting FNR.</p><p><strong>Material and methods: </strong>We searched three databases (Embase, MEDLINE, and Cochrane Central Library) for articles published in the last decade from January 2014 to September 2024. Publications on patients with ECC who underwent SLNB, with information on the FNR of SLNB, were included. The QUADAS-2 tool was used to assess the risk of bias and the clinical applicability of the included studies. The FNR and associated factors were synthesized using random-effects meta-analysis and meta-regression.</p><p><strong>Results: </strong>A total of 49 eligible studies with a low to moderate risk of bias were included in the final analysis. The overall FNR was 10.9% (95 CI: 6.0-16.7). No significant differences in FNR were found for different reference standards or tumor diameters (< 2 cm vs. ≥ 2 cm). However, different tracers (e.g. methylene blue [MB], carbon nanoparticle [CNP], indocyanine green [ICG], and Technetium-99m [Tc-99m] combined with other tracers) appear to account for the different FNRs. In the meta-regression analysis, we found that the proportion of SLNs located in the obturator area was significantly negatively associated with FNR (coefficient = -0.88, p = 0.04).</p><p><strong>Interpretation: </strong>The overall FNR of SLNB for ECC was approximately 10.9%. Factors that tended to reduce the FNR included using a low-volume metastatic detection technique, having a tumor diameter of < 2 cm, employing specific tracer regimens, and identifying more than one lymph node in the obturator fossa.</p><p><strong>Registration: </strong>PROSPERO (CRD42024608411).</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"213-227"},"PeriodicalIF":2.7,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}