The sentinel lymph node biopsy technique in papillary thyroid carcinoma: The issue of false-negative findings

Garau, Ludovico Maria; Rubello, Domenico; Muccioli, Simona; Boni, Giuseppe; Volterrani, Duccio; Manca, Gianpiero

doi:10.1016/j.ejso.2020.02.007

Cited by 20 publications

(23 citation statements)

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“…39 While interest in sentinel lymph node techniques has developed for papillary carcinoma, the clinical utility of this approach is still a topic of debate, with false negative rates reported as high as 40%. 39 Furthermore, when a sentinel lymph node is positive, that typically raises the question of whether further lymph node extirpation beyond the sentinel node is required. The American Thyroid Association guidelines for management of medullary carcinoma advocate for dissection of all required compartments during the initial thyroidectomy because of the complications associated with repeat surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Sentinel lymph node mapping for thyroid carcinoma in man was pioneered by using vital dyes for identification of draining nodes; 38 however, protocols that include lymphoscintigraphy have become more common in recent years 39 . While interest in sentinel lymph node techniques has developed for papillary carcinoma, the clinical utility of this approach is still a topic of debate, with false negative rates reported as high as 40% 39 . Furthermore, when a sentinel lymph node is positive, that typically raises the question of whether further lymph node extirpation beyond the sentinel node is required.…”

Section: Discussionmentioning

confidence: 99%

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Metastasis to ipsilateral medial retropharyngeal and deep cervical lymph nodes in 22 dogs with thyroid carcinoma

2020

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Objective To determine the rate of nodal metastasis to the medial retropharyngeal (MRP) and deep cervical lymph nodes in dogs surgically treated for thyroid carcinoma. Study design Retrospective study. Animals Twenty‐two client‐owned dogs. Methods Medical records between July 2015 and October 2019 at the Universities of Missouri and Florida were reviewed. Dogs that underwent thyroidectomy with concurrent elective MRP lymphadenectomy ± deep cervical lymphadenectomy were included. Tumor site, preoperative staging, and histopathological findings were recorded. Results Twenty‐two dogs with 26 total thyroid carcinomas were included. Primary tumors were lateralized in 19 dogs, bilateral in two dogs, and bilateral and midline ectopic in one dog. All dogs underwent ipsilateral MRP resection, including bilateral resection in dogs with bilateral tumors. Three contralateral MRP lymph nodes were excised from dogs with unilateral carcinomas. Four deep cervical lymph nodes and one superficial cervical lymph node were excised. Metastases were identified in 14 lymph nodes in 10 of 22 (45%) dogs. All four excised deep cervical lymph nodes and one contralateral MRP lymph node were identified as metastatic. Size of deposit could be classified in 13 of 14 metastatic lymph nodes. Macrometastasis was detected in seven lymph nodes, micrometastasis was detected in one node, and isolated tumor cells were detected in five lymph nodes. Conclusion Regional metastasis was common within the lymph nodes sampled in this population of dogs with thyroid carcinoma. Clinical significance These results provide evidence to justify further exploration of a larger population to verify the rate of regional metastasis and determine the prognostic impact of nodal metastasis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metastasis to ipsilateral medial retropharyngeal and deep cervical lymph nodes in 22 dogs with thyroid carcinoma

2020

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“…Дане дослідження не входить до жодного із сучасних протоколів лікування [14]. Також у концепції СЛВ зберігається велика кількість невирішених питань -від оптимальної техніки виконання до алгоритмів застосування та оцінки результатів дослідження [15]. Використання кожної конкретної методики визначення СЛВ багато у чому залежить від доступності тих чи інших діагностичних препаратів та оснащеності медичного закладу [16].…”

Section: обговорення результатівunclassified

“…Пошук методів точної клінічної оцінки стану регіонарних лімфатичних вузлів є перспективним напрямком сучасної онкології у зв'язку з тенденцією до індивідуалізації об'єму оперативного втручання, зокрема визначення показань до органозберігаючого лікування [11,13]. Результати проведеного дослідження показують достатньо високу діагностичну ефективність у порівнянні з іншими методиками та простоту використання [14,15,16]…”

Section: обговорення результатівunclassified

Detection of Sentinel Lymph Nodes in Patients With Thyroid Cancer With the Use of Toluidine Blue

Kurochkin¹,

Moskalenko

et al. 2021

EUMJ

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Introduction. Treatment of patients with thyroid cancer (TС) with clinically undetected metastases to regional lymph nodes remains an unsolved problem of modern oncology. The search for reliable diagnostic methods, which underlie the decision to perform an adequate lymphadenectomy for TC, is one of the priorities of oncosurgery. The aim of the research: to find an effective method of intraoperative contrasting of sentinel lymph nodes (SLN) in patients with TC using toluidine blue and to evaluate its effectiveness. Methods. A study of 123 patients with TC who underwent surgical treatment using the contrast-visual method in the amount of thyroidectomy with central and bilateral selective cervical lymph node dissection (levels VI; IIA; III; IV). During surgery, a 1% solution of toluidine blue was injected into the tumor using a syringe. Surgical treatment was performed in two stages. At the first stage – thyroidectomy was performed in a block with a central lymphatic collector of the neck (level IV), which included removal of paratracheal, prelaryngeal, parathyroid tissue of the neck. Urgent intraoperative histological examination of thyroid tumor and distant SLN was performed. In the second stage of the operation performed cervical lymph node dissection with removal of fiber IIA; III; IV levels of the neck, with mandatory revision of the level of VB. After the operation, the final histological examination of the removed specimen with the tumor and all lymph nodes was performed. Results. After the application contrasting technique, SLN were found in 120 (97.6%) patients. Their number varied from 2 to 12. These lymph nodes were mainly localized in the central collector of the neck on the side of the primary tumor (central, ipsilateral SLN) in 91 (75.8%) patients. Based on the results of an intraoperative study of SLN, metastases were found in 33 (27.5%) of 120 patients. In most cases (83.3%) SLNs were detected in the central lymphatic collector of the neck (level VI). In 76 (63.3%) patients, staining of the lymph nodes of the III level of the neck (middle ipsilateral jugular lymphatic collector) occurred, in 11 (9.2%) SLNs were found only at levels III, IV and VB of the neck. Very rarely (5.8%), the lymph nodes of the anterior-superior mediastinum were contrasted. Conclusions. The method of contrast visualization of the regional collector in patients with TC using a 1% solution of toluidine blue is a highly informative study that allows to determine the regional lymph nodes affected by metastases and to differentiate the choice of the volume of lymph node dissection in the early stages of tumors. The method is simple to implement, does not involve considerable costs and can be recommended for use in oncology clinics.

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“…Nei pazienti con queste neoplasie, l'iniezione intra e/o peritumorale di nanocolloidi radiomarcati con tecnezio-99 pertecnetato permette, mediante l'utilizzo di sonda gamma per chirurgia radioguidata, di individuare il primo linfonodo di drenaggio linfatico dalla sede tumorale, definito linfonodo sentinella [2]. Come riportato da svariate evidenze in letteratura, tale elemento linfonodale è rappresentativo dello stato patologico dell'intero bacino di drenaggio linfatico, rappresentando la prima stazione di eventuale colonizzazione metastatica per via linfatica [3]. La valutazione del linfonodo sentinella permette di ridurre al minimo l'esecuzione di linfoadenectomie superflue, portando a una riduzione dei contestuali rischi operatori e delle complicanze postoperatorie come, per esempio, il linfedema e la limitazione funzionale dell'arto nel caso della neoplasia mam-maria, che spesso impattano significativamente sulla qualità della vita del paziente.…”

Section: Introduzioneunclassified

Il linfonodo sentinella nel carcinoma differenziato della tiroide

Urso

Panareo

2022

L'Endocrinologo

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SommarioLa ricerca del linfonodo sentinella con iniezione di radiocolloidi nel carcinoma differenziato della tiroide (DTC) è ancora oggi una tecnica dibattuta e non comunemente impiegata nella pratica clinica, in quanto attualmente non contemplata dalle linee guida ATA. Obiettivo di questa rassegna è, pertanto, quello di raccogliere attuali luci e ombre della tecnica linfoscintigrafica nel DTC, per stimolare la futura raccolta di nuove evidenze scientifiche che contribuiscano a trovare una standardizzazione procedurale della metodica e una sua più precisa collocazione nel percorso diagnostico-terapeutico dei pazienti con DTC.

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The sentinel lymph node biopsy technique in papillary thyroid carcinoma: The issue of false-negative findings

Cited by 20 publications

References 88 publications

Metastasis to ipsilateral medial retropharyngeal and deep cervical lymph nodes in 22 dogs with thyroid carcinoma

Metastasis to ipsilateral medial retropharyngeal and deep cervical lymph nodes in 22 dogs with thyroid carcinoma

Detection of Sentinel Lymph Nodes in Patients With Thyroid Cancer With the Use of Toluidine Blue

Il linfonodo sentinella nel carcinoma differenziato della tiroide

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