![]() ![]() The aim of the current study is to prospectively review the role of sentinel lymph node biopsy in the management of well differentiated thyroid carcinoma, and to determine the efficacy of intraoperative frozen section analysis at detecting SLN metastasis and central compartment involvement. An accurate SLNB technique is of particular relevance for patients who are found to be SLN negative, in which case the lymphatic basin is considered to be disease-free and the patients, in the case of WDTC, can be spared of CCND and its associated morbidities.Ī SLN technique involving frozen section evaluation allows for a surgeon to assess the necessity for a CCND at the time of the initial surgery and to avoid a potentially more difficult reoperation of the central neck. If the sentinel lymph node is found to be positive for metastasis, there may have had metastatic spread to the remainder of the lymphatic basin. ![]() The sentinel lymph node is defined as the first lymph node draining a regional lymphatic basin from a primary tumor. The notion of sentinel lymph node biopsy (SLNB) relies on the principle of orderly progression of metastasis within a lymphatic basin , squamous cells carcinoma of the head and neck SLNB techniques have also been proposed and are currently being investigated for additional tumor types including gynaecological malignancies Sentinel lymph node biopsy has become a widely adopted technique in the surgical management of melanoma and early stage breast carcinoma. Accordingly, an accurate SLNB technique, if found to be effective, could prove to be a valuable tool in the surgical management patients with WDTC. However, many thyroid surgeons will argue in favour of prophylactic CCND given an incidence of lymph node metastasis reported to be as high as 90% and low rates of morbidity in experienced hands Inherent risks of permanent hypoparathyroidism and vocal cord paresis have swayed against the adoption of routine prophylactic central compartment neck dissection (CCND) as standard management in the context of occult metastasis Though few will question the prognostic value of a therapeutic neck dissection in the context of clinically apparent nodal involvement, its role in the management of occult cervical lymph node metastasis in well differentiated thyroid carcinoma (WDTC) is the source of the debate Surgical management of patients with well differentiated thyroid carcinoma (WDTC) remains controversial. ![]()
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