Methods
Searchstrategy and selection criteria
We performed and reported this systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis of Diagnostic Test Accuracy (PRISMA-DTA) guideline. The study protocol was registered with PROSPERO, number CRD42019130044.
We systematically searched PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (from inception to July 30, 2019) for studies on SLNB with FSE in cervical cancer. The full search strategy was provided in supplementary (p4). No publication date or language restrictions were applied. We manually searched the references of all resulting publications to identify any studies possible missed by the initial search. Besides, we contacted experts in this field with questionnaires for possible unpublished data (supplementary p4–6).
The population of interest was women with cervical cancer initially managed by surgery involving a SLNB procedure combined with FSE. Studies containing these individuals were potentially eligible for review. There were no restrictions for the study purpose or design, methods for SLN detection, or surgical approaches. For qualitative and quantitative synthesis, we included only studies reporting the results of FSE and definitive pathological examination (DPE). Besides, we excluded studies in which the sample size was less than ten, no metastatic case was found, or FSE were selectively performed. In addition, we checked the repetition between studies from the same institution. If two or more studies were found to had irremovable overlaps in studied population, only the most recent study reporting adequate information was included while others were excluded.