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Sentinel Lymph Node Biopsy in Thyroid Cancer

Albers, Max B. ; Nordenström, Erik LU ; Wohlfahrt, Johan LU ; Bergenfelz, Anders LU and Almquist, Martin LU (2020) In World Journal of Surgery 44. p.142-147
Abstract

Background: Prophylactic central neck dissection in patients with papillary thyroid carcinoma is controversial. Sentinel node biopsy might be an adjunct to optimize surgical treatment for these patients. Earlier studies reported inconsistent detection rates and diagnostic value of this technique, and the role of sentinel lymph node biopsy in thyroid cancer needs to be established. Patients and methods: During a single-center prospective interventional study between 2010 and 2017, sentinel lymph node biopsy using 99mTc-nanocolloidal albumin tracer was performed on patients undergoing thyroid surgery for suspected thyroid cancer by fine needle aspiration cytology. All eligible patients without clinical lymph node involvement were invited... (More)

Background: Prophylactic central neck dissection in patients with papillary thyroid carcinoma is controversial. Sentinel node biopsy might be an adjunct to optimize surgical treatment for these patients. Earlier studies reported inconsistent detection rates and diagnostic value of this technique, and the role of sentinel lymph node biopsy in thyroid cancer needs to be established. Patients and methods: During a single-center prospective interventional study between 2010 and 2017, sentinel lymph node biopsy using 99mTc-nanocolloidal albumin tracer was performed on patients undergoing thyroid surgery for suspected thyroid cancer by fine needle aspiration cytology. All eligible patients without clinical lymph node involvement were invited to participate. Central neck dissection was performed on all patients after the detection of sentinel lymph nodes. Results: Ninety-six patients participated in the study. The detection rates of the sentinel node were 67% and 45% by scintigraphy and intraoperative gamma probe, respectively. The detection rate was not associated with Bethesda score, malignancy, or presence of lymph node metastases. Sensitivity, negative predictive value, and accuracy were 80%, 97%, and 98%, respectively, for the sentinel node to represent the status of lymph node metastasis in the central neck compartment. The false negative rate was 20%. Conclusion: Sentinel lymph node biopsy had a low detection rate and only moderate sensitivity in patients with suspected thyroid carcinoma and is not a useful adjunct to surgery in the context of current treatment concepts.

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publishing date
type
Contribution to journal
publication status
published
subject
in
World Journal of Surgery
volume
44
pages
6 pages
publisher
Springer
external identifiers
  • pmid:31583456
  • scopus:85073944363
ISSN
0364-2313
DOI
10.1007/s00268-019-05218-1
language
English
LU publication?
yes
id
cf5c9846-d388-4c53-a5b7-981aeb5f8726
date added to LUP
2019-11-07 09:39:52
date last changed
2024-04-02 19:56:20
@article{cf5c9846-d388-4c53-a5b7-981aeb5f8726,
  abstract     = {{<p>Background: Prophylactic central neck dissection in patients with papillary thyroid carcinoma is controversial. Sentinel node biopsy might be an adjunct to optimize surgical treatment for these patients. Earlier studies reported inconsistent detection rates and diagnostic value of this technique, and the role of sentinel lymph node biopsy in thyroid cancer needs to be established. Patients and methods: During a single-center prospective interventional study between 2010 and 2017, sentinel lymph node biopsy using 99mTc-nanocolloidal albumin tracer was performed on patients undergoing thyroid surgery for suspected thyroid cancer by fine needle aspiration cytology. All eligible patients without clinical lymph node involvement were invited to participate. Central neck dissection was performed on all patients after the detection of sentinel lymph nodes. Results: Ninety-six patients participated in the study. The detection rates of the sentinel node were 67% and 45% by scintigraphy and intraoperative gamma probe, respectively. The detection rate was not associated with Bethesda score, malignancy, or presence of lymph node metastases. Sensitivity, negative predictive value, and accuracy were 80%, 97%, and 98%, respectively, for the sentinel node to represent the status of lymph node metastasis in the central neck compartment. The false negative rate was 20%. Conclusion: Sentinel lymph node biopsy had a low detection rate and only moderate sensitivity in patients with suspected thyroid carcinoma and is not a useful adjunct to surgery in the context of current treatment concepts.</p>}},
  author       = {{Albers, Max B. and Nordenström, Erik and Wohlfahrt, Johan and Bergenfelz, Anders and Almquist, Martin}},
  issn         = {{0364-2313}},
  language     = {{eng}},
  pages        = {{142--147}},
  publisher    = {{Springer}},
  series       = {{World Journal of Surgery}},
  title        = {{Sentinel Lymph Node Biopsy in Thyroid Cancer}},
  url          = {{http://dx.doi.org/10.1007/s00268-019-05218-1}},
  doi          = {{10.1007/s00268-019-05218-1}},
  volume       = {{44}},
  year         = {{2020}},
}