The Role of Sentinel Lymph Node Biopsy in Patients with Papillary Thyroid Carcinoma

Document Type : Original Article

Authors

1 Department of Oncosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Patients who have already been diagnosed with cancer are candidates for a technique known as sentinel lymph node biopsy [SLNB]. During this surgery, the sentinel lymph node is found, removed, and biopsied in order to determine whether or not it contains cancer cells.
The aim of the work: The aim of this study was to discuss the validity of SLN biopsy in guiding Central Compartment Neck Dissection [CCND] in patients with papillary thyroid carcinoma and clinically negative lymph nodes [PTC cN0] using histopathology as a standard.
Patients and Methods: The Department of Oncologic Surgery at Al-Azhar University Hospitals in Cairo, Egypt conducted this prospective, randomized study. Thirty patients were diagnosed with papillary thyroid cancer. Patients underwent complete thyroidectomies and sentinel lymph node biopsies. A consulting surgeon performed or oversaw all procedures.
Results: Thirty patients with papillary thyroid cancer visited the Oncologic surgical outpatient clinic. Of the 30 patients with malignant cases, 24 [accuracy] had lymph nodes that were initially regarded as sentinels. Lymph node metastasis in SLN was found to be positive in 60% and negative in 20% of the detected SLNs [65% & 15% of overall patients], but in non-SLN was positive in 53.3% and negative in 46.6% of the detected NSLNs [47% & 45% of overall patients]. From our outcomes, SLN had a Sensitivity, Specificity, positive and negative Predictive Values of 91.61%, 100%, 100 percent and 75 percent respectively, with an overall accuracy of 18/30 [60%].
Conclusion: Although SLNB may have a place in the normal care of thyroid cancer, its efficacy needs more research and evaluation on larger patient series before it can be recommended for this purpose.

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