Accuracy of sentinel lymph node in papillary thyroid carcinoma

Sentinel lymph node biopsy as guidance for central neck dissection in patients with papillary thyroid carcinoma

“…[8][9][10][11][12]14,15 Our findings were similar to those reports, because most SLNs in the current were located in the central compartment, and <20% were located in the jugular region. [8][9][10][11][12][13][14][15] Thus, SLN biopsy may guide compartment-oriented neck dissection, particularly in the central compartment. In addition, SLN biopsy of lymph nodes that drain first to the jugular region may determine whether to perform modified radical neck dissection, 15 a finding supported by 1 of our patients, who had a positive SLN in the lower jugular region and subsequently underwent lateral neck dissection.…”

“…Our and previous reports [8][9][10][11][12][13][14][15] suggest that SLN biopsy in patients who have PTC without suspected cervical lymphadenopathy can identify occult metastases early and can avoid the morbidity associated with routine and unnecessary lymph node dissection, 34 especially in the central cervical compartment. In addition, we have tried to reduce the morbidity of central neck dissection, including postoperative hypoparathyroidism, by the routine use of oral calcium and vitamin D during the early postoperative period.…”

“…19,20 Patients with PTC have a high rate of regional metastasis, with clinically apparent lymph node involvement in 15% to 50% 21 and occult metastasis in 40% to 90%. [8][9][10][11][12][13][14][15]22 We reported previously that, in 82 patients with clinically positive and negative lymph nodes, the overall metastasis rates were 62.2% in the central neck and 25.6% in the lateral neck. 5 In the current study, we observed that the metastasis rate was 36% in patients without clinical and US-detected lymph node involvement.…”

“…SLN reportedly has a sensitivity from 71% to 100%, a specificity of 100%, and a diagnostic accuracy ranging from 75% to 100% for predicting disease status in the remaining regional lymph node basin. [8][9][10][11][12][13][14][15]17 Diagnostic sensitivity may improve by using an intraoperative immunohistochemical stain for cytokeratin-7.…”

“…Subclinical lymph node metastases can be detected by biopsy of the sentinel lymph node (SLN), which is defined as the first lymph node draining a regional lymphatic basin from a primary tumor. [8][9][10][11][12][13][14][15][16][17][18] SLN sampling may avoid unnecessary lymph node dissection in patients with PTC who do not demonstrate spread to regional lymph nodes. Studies in larger cohorts of patients undergoing complete central neck lymph node dissection, including patients whose lymph nodes did not stain, may be required to establish the utility of SLN sampling.…”