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Sentinel lymphadenectomy in thyroid malignant neoplasms
P R Kelemen1, A J Van Herle, A E Giuliano
1John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, Calif 90404, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|March 28, 1998
Summary
Sentinel lymph node dissection (SLND) is a feasible technique for detecting nonpalpable lymph node metastasis in thyroid cancer. This method shows promise for improving recurrence rates in well-differentiated thyroid cancer management.
Area of Science:
- Oncology
- Surgical Oncology
- Nuclear Medicine
Background:
- Well-differentiated thyroid cancer with lymph node metastases has high recurrence rates.
- Current surgical options include blind nodal sampling, berry-picking, and modified radical neck dissections.
- Sentinel lymph node dissection (SLND) has demonstrated success in melanoma and breast cancer management.
Purpose of the Study:
- To investigate the feasibility of sentinel lymph node dissection (SLND) for thyroid cancer.
- To evaluate intraoperative lymphatic mapping and SLND in patients with suspicious thyroid nodules.
Main Methods:
- Intraoperative lymphatic mapping and SLND were performed on 17 patients with suspicious thyroid nodules.
- Isosulfan blue dye was injected into the thyroid mass to identify the sentinel lymph node.
- Sentinel lymph nodes were examined via routine processing and immunohistochemical analysis for micrometastasis.
Main Results:
- SLND was successful in 15 of 17 patients; lymphatic mapping failed in 2.
- Of 12 thyroid carcinoma cases, 5 (42%) had positive sentinel lymph nodes.
- In 17% of cases, the sentinel node was the only tumor-bearing lymph node identified.
Conclusions:
- This study reports the first application of SLND for thyroid carcinoma.
- SLND can effectively detect nonpalpable nodal metastasis in thyroid cancer.
- Further research is needed to determine the clinical significance of SLND in thyroid cancer.