Sentinel lymph node biopsy accuracy in PTC neck negative disease

Introduction Although reccurence rate of thyroid pappilary carcinoma is rare and according to literature is 2 % on global level, proponents of neck dissection insist on performing it along thyroid surgery even if nodes are not palpable. Rationale behind this approach is that after histological examination of dissected nodes, micrometastases are found in over half of patients.

Aim of this study is to determine sensitivity, specificity and accuracy of Sentinel lymph node biopsy in patients with PTC with no neck metastatic disease as opposed to neck dissection with PHD.

Objectives of this cohort study were to determine whether SLNB biopsy in patients with papillar thyroid carcinoma is capable of discriminating true lymph node negative patients with those with non palpabile metastatic lymph nodes and whether SLNB could provide an alternative to elective lymph node dissection

Patients and methodes Patients with preoperative diagnosis of PTC diagnosed with FNAB

Exclusion criteria cervical lymphadenopathy,chronic thyreoiditis.

Results Total of 48 patients(40 females,8 males,age range 25-69 years,mean age 43) operated in ENT clinic of Sarajevo Clinical center in year 2019. Primary tumor span was between 1,2 and 4,6 cm). All patients had a solitary plapabile tumor and no palpabile cervical lymphadenopathy. SLNB was preformed in 43 of 48 patients (89,5 %).

Concordance between SLNB and PHD analysis was 83 % ( 36/43) . We have found accuracy of SNLB to be 91 %, sensitivity 85 %, 100 % positive predictive value and 86 % negative predicitive value.

Conclusion/Discusion SLNB, along with other methods, has enough predicitve value preoperatively to avoid dissection although dissection, in our facility, remains operative staple in management of pappilary thyroid carcinoma regardless of SNLB status.

Publikationsverlauf

Artikel online veröffentlicht:
10. Juni 2020