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Sentinel Lymph Node Biopsy for Papillary Thyroid Cancer: 12 Years of Experience at a Single Institution

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to report our experience with sentinel lymph node dissection (SLND) for papillary thyroid carcinoma, to evaluate the feasibility and safety of the procedure, and to examine its potential utility as a guide for central neck dissection.

Materials and Methods

A retrospective chart review of patients undergoing total thyroidectomy from January 1998 thru January 2010 was conducted. Intratumoral injection of blue dye was used to identify the SLN. Central neck dissection (CND) was performed if the SLN was positive on frozen section. Locally advanced disease, previous thyroid surgery, or lymphadenopathy on preoperative imaging or intraoperative palpation were exclusion criteria.

Results

A total of 211 patients underwent SLN mapping. Of these, 165 patients (78%) were female and 46 (22%) were male. Also, 75 (36%) were ≤45 years of age, and 136 (64%) were older than 45. Tumors were ≤2.0 cm (T1) in 142 patients (67%), 2–4 cm (T2) in 35 patients (17%), >4 cm with minimal invasion (T3) in 32 patients (15%), and locally invasive (T4) in 2 patients (1%). At least 1 blue node was found in 192 patients (91%). Also, 47 patients had a positive SLN on frozen section, with an additional 24 node-positive patients on permanent section, for a total of 71 (37%). There were 43 patients (91%) who underwent central neck dissection; 26 (60%) had additional metastases.

Conclusions

Sentinel lymphadenectomy for papillary thyroid carcinoma is feasible, safe, and can identify patients who may benefit from central neck dissection.

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Acknowledgment

From the Gonda (Goldschmied) Research Laboratories of the John Wayne Cancer Institute at Saint John’s Health Center. Supported by funding from the Margie and Robert E. Petersen Foundation (Los Angeles, CA), QVC and the Fashion Footwear Association of New York Charitable Foundation (New York, NY), Mrs. Lois Rosen (Los Angeles, CA), and Maria Lucia and Fernando Diez Barroso (Beverly Hills, CA).

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Authors and Affiliations

  1. Department of Surgical Oncology, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA

    Deborah K. Cunningham MD, Katherine A. Yao MD & Armando E. Giuliano MD

  2. Department of Pathology, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA

    Roderick R. Turner MD

  3. Department of Endocrinology, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA

    Frederick R. Singer MD

  4. Department of Medicine, Division of Endocrinology, University of California at Los Angeles, Los Angeles, CA, USA

    Andre R. Van Herle

Authors
  1. Deborah K. Cunningham MD
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  2. Katherine A. Yao MD
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  3. Roderick R. Turner MD
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  4. Frederick R. Singer MD
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  5. Andre R. Van Herle
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  6. Armando E. Giuliano MD
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Corresponding author

Correspondence to Armando E. Giuliano MD.

Additional information

Presented in part at the Annual Meeting of the Society of Surgical Oncology, March 2010, St. Louis, MO.

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Cunningham, D.K., Yao, K.A., Turner, R.R. et al. Sentinel Lymph Node Biopsy for Papillary Thyroid Cancer: 12 Years of Experience at a Single Institution. Ann Surg Oncol 17, 2970–2975 (2010). https://doi.org/10.1245/s10434-010-1141-x

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  • DOI: https://doi.org/10.1245/s10434-010-1141-x

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