ECE2014 Poster Presentations Thyroid Cancer (70 abstracts)
Sentinel lymph node biopsy in thyroid papillary and medullary microcarcinomas
Radan Dzodic 1, , Merima Oruci 1 , Nikola Besic 3 , Nada Santrac 1 , Ivan Markovic 1, , Gordana Pupic 1 & Natasa Milic 2
1Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; 2School of Medicine, University of Belgrade, Belgrade, Serbia; 3Institute for Oncology, University of Ljubljana, Ljubljana, Slovenia.
Introduction: The aim of this study was to determine whether sentinel lymph node (SLN) biopsy of jugulo-carotid chain (JCC) in thyroid microcarcinomas (TMC) is an accurate technique to select patients with true positive, but clinically and ultrasonically N0 LNs, for modified radical neck dissection (MRND).
Materials and methods: In total 199 patients with TMC underwent total thyroidectomy, central neck dissection and SLN mapping with 0.2 ml of 1% methylene blue injected in thyroid gland. SLNs, identified in JCC, were examined by frozen section as a determination factor for additional MRND. All data were statistically analyzed.
Results: In our study, 93% of patients had papillary TMC, 6% medullary TMC, while 1% had these two combined. Definitive pathohistology showed a 96.48% match with frozen-section analysis results – a total of 21 (10.55%) patients with papillary TMC had positive SLNs, with no false-positive findings. They were treated with MRND of the positive JCC, additionally to total thyroidectomy and central neck dissection. Analysis showed more frequent lateral metastases in patients with tumors 5 mm or less in diameter (12.88%) than in larger ones (7.46%). Method’s accuracy is 95%.
Discussion and conclusions: Data showed that SLN biopsy precisely determines patients with lateral neck compartment metastases, even if clinically and ultrasonically staged N0. Tumor size cannot predict lateral metastases. There were no LN metastases in medullary TMC. Using SLN biopsy for intraoperative assessment of lateral LN one can avoid unnecessary MRND. In addition, this method helps optimizing ablative radioiodine treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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