Lateral neck sentinel lymph node biopsy in papillary thyroid carcinoma, is it really necessary? A randomized,...

Area of Science:

• Oncology
• Nuclear Medicine
• Surgical Oncology

Background:

• Occult metastasis to lateral neck lymph nodes is common in papillary thyroid carcinoma (PTC).
• The clinical significance of these metastases and the role of sentinel lymph node biopsy (SLNB) in preventing recurrence are not well understood.

Purpose of the Study:

• To investigate the impact of lateral SLNB using radioisotopes in detecting occult metastases in PTC.
• To evaluate whether SLNB can prevent recurrence and affect thyroglobulin (Tg) levels.

Main Methods:

• A randomized controlled study involving 283 PTC patients.
• 141 patients underwent lateral SLNB (LSLNB), while 142 served as controls.
• Follow-up included stimulated thyroglobulin (sTg) measurements and recurrence assessment over a median of 39 months.

Main Results:

• LSLNB identified lateral sentinel lymph nodes (LSLNs) in 63% of eligible patients.
• Metastases were found in 30% of patients with identified LSLNs.
• No significant difference in sTg levels or recurrence rates was observed between the LSLNB and control groups at a median follow-up of 39 months.

Conclusions:

• Lateral SLNB can detect occult metastases in PTC patients.
• The procedure did not demonstrate a significant impact on sTg levels or recurrence rates within the study's follow-up period.
• Long-term studies are necessary to fully ascertain the clinical benefit of LSLNB in preventing PTC recurrence.