Sentinel lymph node mapping: current applications and future perspectives in thyroid carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Sentinel lymph node (SLN) mapping is crucial for staging solid tumors like melanoma and breast cancer.
• Papillary thyroid carcinoma (PTC) frequently presents with cervical lymph node metastases (20-90%), impacting recurrence.
• SLN mapping in PTC offers an alternative to prophylactic central neck dissection for staging N0 patients.

Purpose of the Study:

• To review and summarize the various methods and outcomes of SLN mapping in thyroid cancer (TC).
• To discuss the current role, indications, advantages, and limitations of SLN procedures in TC management.

Main Methods:

• Review of existing literature on SLN identification techniques in TC.
• Description of methods including vital-dye (VD) mapping, lymphoscintigraphy (LS) with gamma probe, and SPECT-CT.
• Comparison of combined LS + VD and LS + SPECT/CT approaches.

Main Results:

• SLN mapping is utilized for staging preoperative N0 patients with PTC.
• It aids in detecting metastatic lymph nodes within and outside the central cervical compartment.
• Current techniques for SLN identification in TC are diverse and not standardized.

Conclusions:

• SLN mapping is a valuable tool in the surgical management of thyroid cancer.
• Despite its potential, the heterogeneity of techniques and ongoing debate highlight the need for standardization.
• Further research is needed to define the optimal role and indications for SLN in TC.