[Application of mitoxantrone hydrochloride in lymph node imaging during radical thyroidectomy]

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• Thyroid cancer surgery requires precise identification of lymph nodes, parathyroid glands, and the recurrent laryngeal nerve.
• Current lymph node tracers have limitations in sensitivity and specificity.
• Minimizing collateral damage to vital structures is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the clinical utility of mitoxantrone hydrochloride (MHI) as a novel tracer in thyroid cancer surgery.
• To compare MHI's effectiveness with nanocarbon tracers and a control group for lymph node imaging and vital structure identification.
• To assess the impact of MHI on surgical outcomes and patient safety.

Main Methods:

• A prospective controlled study involving 180 thyroid cancer patients randomly assigned to MHI, nanocarbon, or control groups.
• Comparison of detected lymph nodes, metastatic nodes, surgical field clarity, and parathyroid gland identification rates.
• Analysis of perioperative serum calcium and parathyroid hormone (PTH) levels and treatment-related complications.

Main Results:

• MHI group showed significantly higher staining intensity, tracer success rate, and surgical field clarity than the nanocarbon group.
• MHI significantly improved lymph node dissection and parathyroid gland identification rates compared to both nanocarbon and control groups.
• Both MHI and nanocarbon groups had lower rates of inadvertent parathyroid excision and fewer complications like tetany compared to the control group.

Conclusions:

• Mitoxantrone hydrochloride offers superior performance in lymph node tracing and surgical field visualization during thyroid cancer surgery.
• MHI effectively reduces the risk of damage to the recurrent laryngeal nerve and parathyroid glands.
• MHI represents a promising advancement for improving safety and outcomes in radical thyroidectomy.