Sentinel lymph node dissection in papillary thyroid carcinoma

Chow, Tam‐Lin; Lim, Boon-Hua; Kwok, S.P.Y.

doi:10.1046/j.1445-1433.2003.02677.x

Cited by 38 publications

(28 citation statements)

References 14 publications

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“…We used an intra-tumoural injection technique which theoretically could decrease the sentinel node detection rate due to poor lymphatic drainage from the tumour parenchyma compared to the peri-tumoural area [20,21]. Several groups have also used intra-tumoural injection of the mapping material for thyroid cancer patients with the same results as ours (about 60% SLN detection rate) [22][23][24], which corroborate our results. Another possible reason for the low detection rate in our study compared to the previous studies is the learning curve effect.…”

Section: Discussionsupporting

confidence: 81%

Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy z zastosowaniem radioznacznika i niebieskiego barwnika

Assadi¹,

Yarani²,

Jangjoo³

et al. 2014

Endokrynologia Polska

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Introduction: In the current study, we evaluated the accuracy of sentinel node mapping in thyroid cancer patients using both radiotracer and blue dye. Material and methods: 30 patients with a diagnosis of papillary thyroid carcinoma (PTC) were included in the study; 2-3 hours before surgery, 0.5 mCi 99m-Tc-Antimony Sulfide Colloid was injected intra-tumourally. 15 minutes post-injection, lymphoscintigraphy images of the neck were obtained. Immediately after anaesthesia induction, 0.5 mL patent blue V was also injected in the same fashion. Sentinel lymph nodes were detected intraoperatively using gamma probe and blue dye. Total thyroidectomy was performed for all patients with dissection of central neck lymph nodes as well as sampling of the lateral neck lymph nodes. Results: At least one sentinel node could be identified during surgery in 19 patients (63.3%). The median number of sentinel nodes per patient was 1. Sentinel nodes in 12 patients were pathologically involved. No false negative case was noted. Upstaging occurred in six patients (20%). Conclusions: Sentinel node mapping in papillary thyroid carcinoma is a feasible technique with high accuracy for the detection of lymph node involvement. This technique can guide surgeons to perform central lymph node dissection only in patients with pathologically involved sentinel nodes. Although SLN detection in the lateral neck lymph nodes increases the extension of lymphadenectomy, SLN mapping can result in upstaging in older patients (> 45 years of age) or treatment plan change in younger patients (< 45 years of age) by the detection of lateral lymph node involvement. (Endokrynol Pol 2014; 65 (4): 281-286)

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Section: Discussionsupporting

confidence: 81%

Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy z zastosowaniem radioznacznika i niebieskiego barwnika

Assadi¹,

Yarani²,

Jangjoo³

et al. 2014

Endokrynologia Polska

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“…Whether these statistics apply to micrometastases not identified by ultrasound or other scans is unknown. There is a rich lymphatic drainage system associated with the thyroid gland, which is evident when up to 70% of patients demonstrate more than one sentinel node [36]. In addition, the phenomenon of skip metastases has also been demonstrated with SLN mapping, with 20% of sentinel lymph nodes identified in the lateral nodal compartments [36].…”

Section: Sentinel Lymph Node Biopsymentioning

confidence: 97%

“…There is a rich lymphatic drainage system associated with the thyroid gland, which is evident when up to 70% of patients demonstrate more than one sentinel node [36]. In addition, the phenomenon of skip metastases has also been demonstrated with SLN mapping, with 20% of sentinel lymph nodes identified in the lateral nodal compartments [36]. Although SLN biopsies are safe and with no significant morbidity, the role of any investigation that identifies lymph node disease not clinically evident is debated.…”

Section: Sentinel Lymph Node Biopsymentioning

confidence: 97%

Papillary thyroid cancer: Surgical management of lymph node metastases

Caron

Clark

2005

Curr. Treat. Options in Oncol.

101

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Papillary thyroid cancer (PTC), the most common thyroid malignancy, is associated with cervical lymph node metastases in 30% to 90% of patients. While surgery is the primary treatment modality for PTC, radioactive iodine and thyroid hormone suppression often complement the treatment plan. Although thyroid hormone suppression may decrease the incidence of recurrent disease and radioactive iodine may diagnose and treat metastases, lymph node dissection (LND) is the mainstay treatment for clinically evident cervical lymph node metastases. The surgical treatment options published in the literature include the traditional radical LND, the modified radical LND, the selective LND (compartment-based resection based on documented lymph node metastases), and a 'berry picking' resection (in which only the grossly abnormal lymph nodes are excised). At the University of California, San Francisco, we prefer the modified radical LND with preservation of the cervical sensory nerves for the first lymph node dissection with the 'berry picking' procedure limited to surgical treatment of recurrent nodal metastases in previously resected lymph node basins. Some centers are evaluating the potential role of sentinel lymph node biopsies for PTC. While the extent of lymphadenectomy is debated, most physicians treating patients with PTC agree that clinical evidence of lymphatic metastases should be surgically exercised and there is no role for prophylactic LND.

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“…38 Preoperative diagnosis was DTC in 4 studies 20,28,29,38 and PTC in 21 studies. [13][14][15][16][17][18][19]21,22,[24][25][26][27][30][31][32][33][34][35][36][37] In 2006, Abdalla 23 studied 30 patients with a preoperative diagnosis of benign thyroid nodule. The histological diagnosis of PTC ranged between a minimum of 8 patients 22,29 and a maximum of 153 patients.…”

Section: Vital Dye Techniquementioning

confidence: 99%

Lymphoscintigraphy in Differentiated Thyroid Cancer

Boschin¹,

Pelizzo

Giammarile

et al. 2015

Clinical Nuclear Medicine

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There is considerable variability in the surgical approach to differentiated thyroid cancer regarding the decision to explore and remove central or central and lateral compartment lymph nodes. Much as sentinel lymph node sampling has improved the decision to remove axillary nodes for breast cancer, vital dye and lymphoscintigraphy with lymph node sampling may direct the surgical approach to differentiated thyroid cancer.

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Sentinel lymph node dissection in papillary thyroid carcinoma

Abstract: Occult nodal spread is frequently encountered in papillary thyroid carcinoma. SLN biopsy is safe and feasible in papillary thyroid cancer, however further studies are necessary to improve the diagnostic accuracy prior to routine clinical use.

Cited by 38 publications

References 14 publications

Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy z zastosowaniem radioznacznika i niebieskiego barwnika

Mapowanie węzłów wartowniczych w raku brodawkowatym tarczycy z zastosowaniem radioznacznika i niebieskiego barwnika

Papillary thyroid cancer: Surgical management of lymph node metastases

Lymphoscintigraphy in Differentiated Thyroid Cancer

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