Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 37 GP23.02 | DOI: 10.1530/endoabs.37.GP.23.02

ECE2015 Guided Posters Thyroid – diagnosis (9 abstracts)

Accuracy of sentinel lymph node biopsy in papillary thyroid carcinoma in decision for selective lateral neck dissection

Ivan Markovic 1, , Marko Buta 1 , Merima Oruci 1 , Igor Djurisic 1 , Nada Santrac 1 , Gordana Pupic 1 , Andjela Babic 1 , Marija Markovic 1 & Radan Dzodic 1,


1Institute of Oncology and Radiology of Serbia, Belgrade, Serbia; 2Medical Faculty University of Belgrade, Belgrade, Serbia.


Introduction: The incidence of occult lymph node metastases (LNM) in papillary thyroid carcinoma (PTC) reaches 80%, still their surgical management in clinically node negative (cN0) patients remains controversial and ranges from ‘wait and see’ principle to prophylactic dissections of both central and lateral neck compartments. This encouraged some authors to apply the concept of sentinel lymph node biopsy (SLNb) in PTC. Our aim to investigate if SLNb using methylene blue dye is accurate in detection of LNM in lateral neck compartment and may help in decision for selective modified lateral neck dissection in cN0 patients with PTC.

Study design: Study included 153 cN0 patients with PTC. All underwent total thyroidectomy with prophylactic central neck dissection and SLNb of lateral lymph nodes using methylene blue dye with selective modified lateral neck dissection in metastatic SLNs.

Results: Over 80% of patients had pT1 tumours, including 57% of microcarcinoma. Neck LNM were histologically verified in 40.9% of cases. Central neck compartment LNM were predictive for lateral LNM in 80.5% of cases. Predictive factors for LNM were: male gender, patients younger than 45 years, tumours greater than 1 cm, capsular and vascular tumour invasion. Our method enabled detection of metastases in 21% of SLN in lateral neck compartment, which were over 50% predictive of metastasis to other lateral lymph nodes. SLN identification rate (IR) was 91.81%. Sensitivity, specificity, positive and negative predictive value were 85.7, 96.7, 88.3 and 95.9% respectively. The overall accuracy of the method was 94.3%, with 91.2% probability of repeating the results in the second specimen (ROC AUC, 95% CI; 84.2–98.3%).

Conclusion: The proposed method of SLN biopsy is feasible, safe and accurate in detection of additional LNM in the lateral neck compartment and may help in decision for selective modified lateral neck dissection in cN0 patients with PTC.

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