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Use of preoperative lymphoscintigraphy and intraoperative gamma-probe detection for identification of the sentinel lymph node in patients with papillary thyroid carcinoma

Abstract Aims Lymph node metastases for papillary thyroid carcinoma are associated with an increased incidence of locoregional recurrence. The use of preoperative lymphoscintigraphy and intraoperative gamma probe detection to localize the sentinel lymph node in papillary thyroid carcinoma was invest...

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Published in:European journal of surgical oncology 2007-11, Vol.33 (9), p.1075-1080
Main Authors: Carcoforo, P, Feggi, L, Trasforini, G, Lanzara, S, Sortini, D, Zulian, V, Pansini, G.C, Degli Uberti, E, Liboni, A
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container_issue 9
container_start_page 1075
container_title European journal of surgical oncology
container_volume 33
creator Carcoforo, P
Feggi, L
Trasforini, G
Lanzara, S
Sortini, D
Zulian, V
Pansini, G.C
Degli Uberti, E
Liboni, A
description Abstract Aims Lymph node metastases for papillary thyroid carcinoma are associated with an increased incidence of locoregional recurrence. The use of preoperative lymphoscintigraphy and intraoperative gamma probe detection to localize the sentinel lymph node in papillary thyroid carcinoma was investigated. Methods From February 2004 to December 2005 the sentinel lymph node technique was studied in 64 consecutive patients with cytological evidence of papillary thyroid carcinoma. The day before surgery, patients were submitted to US-guided peri-tumoural injection of the radiotracer and a lymphoscintigraphy was performed. In the operating room a total thyroidectomy was done, and thanks to a hand-held gamma probe the sentinel lymph node and all lymph nodes, belonging to the sentinel node compartment, were removed. Results The gamma probe identified the sentinel lymph node in 62 patients (96.8%). We found 48 (77.5%) sentinel lymph node without metastases; 12 (19.3%) with metastases and 2 (3.2%) with micrometastases. In 7 cases (11.3%), with a negative sentinel lymph node, metastases in other nodes of the same region were recorded. In 22 cases (34.3%) the ultrasound give an erroneous indication ( P = 0.004). Five patients (8.0%), 4 with multifocal cancer, had a positive postoperative lymphoscintigraphy. Conclusion This study shows that the sentinel lymph node technique for papillary thyroid carcinoma is feasible, repeatable, and more accurate than preoperative ultrasound. In cases of multifocal thyroid lesions more patients should be enrolled to establish the utility of the radio-guided technique.
doi_str_mv 10.1016/j.ejso.2007.01.025
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The use of preoperative lymphoscintigraphy and intraoperative gamma probe detection to localize the sentinel lymph node in papillary thyroid carcinoma was investigated. Methods From February 2004 to December 2005 the sentinel lymph node technique was studied in 64 consecutive patients with cytological evidence of papillary thyroid carcinoma. The day before surgery, patients were submitted to US-guided peri-tumoural injection of the radiotracer and a lymphoscintigraphy was performed. In the operating room a total thyroidectomy was done, and thanks to a hand-held gamma probe the sentinel lymph node and all lymph nodes, belonging to the sentinel node compartment, were removed. Results The gamma probe identified the sentinel lymph node in 62 patients (96.8%). We found 48 (77.5%) sentinel lymph node without metastases; 12 (19.3%) with metastases and 2 (3.2%) with micrometastases. In 7 cases (11.3%), with a negative sentinel lymph node, metastases in other nodes of the same region were recorded. In 22 cases (34.3%) the ultrasound give an erroneous indication ( P = 0.004). Five patients (8.0%), 4 with multifocal cancer, had a positive postoperative lymphoscintigraphy. Conclusion This study shows that the sentinel lymph node technique for papillary thyroid carcinoma is feasible, repeatable, and more accurate than preoperative ultrasound. In cases of multifocal thyroid lesions more patients should be enrolled to establish the utility of the radio-guided technique.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2007.01.025</identifier><identifier>PMID: 17344018</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary - diagnostic imaging ; Carcinoma, Papillary - secondary ; Carcinoma, Papillary - surgery ; Female ; Gamma Rays ; Hematology, Oncology and Palliative Medicine ; Humans ; Laterocervical lymphoadenectomy ; Lymph Node Excision ; Lymph Nodes - diagnostic imaging ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; Papillary thyroid carcinoma ; Preoperative Care ; Radionuclide Imaging ; Sentinel lymph node ; Sentinel Lymph Node Biopsy - methods ; Surgery ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Ultrasonography</subject><ispartof>European journal of surgical oncology, 2007-11, Vol.33 (9), p.1075-1080</ispartof><rights>2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-a1e3edb5f6c1d5a9de5e69b119eedc13c89b920446577e7f02f2b9e2d9e9826e3</citedby><cites>FETCH-LOGICAL-c409t-a1e3edb5f6c1d5a9de5e69b119eedc13c89b920446577e7f02f2b9e2d9e9826e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17344018$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carcoforo, P</creatorcontrib><creatorcontrib>Feggi, L</creatorcontrib><creatorcontrib>Trasforini, G</creatorcontrib><creatorcontrib>Lanzara, S</creatorcontrib><creatorcontrib>Sortini, D</creatorcontrib><creatorcontrib>Zulian, V</creatorcontrib><creatorcontrib>Pansini, G.C</creatorcontrib><creatorcontrib>Degli Uberti, E</creatorcontrib><creatorcontrib>Liboni, A</creatorcontrib><title>Use of preoperative lymphoscintigraphy and intraoperative gamma-probe detection for identification of the sentinel lymph node in patients with papillary thyroid carcinoma</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Abstract Aims Lymph node metastases for papillary thyroid carcinoma are associated with an increased incidence of locoregional recurrence. The use of preoperative lymphoscintigraphy and intraoperative gamma probe detection to localize the sentinel lymph node in papillary thyroid carcinoma was investigated. Methods From February 2004 to December 2005 the sentinel lymph node technique was studied in 64 consecutive patients with cytological evidence of papillary thyroid carcinoma. The day before surgery, patients were submitted to US-guided peri-tumoural injection of the radiotracer and a lymphoscintigraphy was performed. In the operating room a total thyroidectomy was done, and thanks to a hand-held gamma probe the sentinel lymph node and all lymph nodes, belonging to the sentinel node compartment, were removed. Results The gamma probe identified the sentinel lymph node in 62 patients (96.8%). We found 48 (77.5%) sentinel lymph node without metastases; 12 (19.3%) with metastases and 2 (3.2%) with micrometastases. In 7 cases (11.3%), with a negative sentinel lymph node, metastases in other nodes of the same region were recorded. In 22 cases (34.3%) the ultrasound give an erroneous indication ( P = 0.004). Five patients (8.0%), 4 with multifocal cancer, had a positive postoperative lymphoscintigraphy. Conclusion This study shows that the sentinel lymph node technique for papillary thyroid carcinoma is feasible, repeatable, and more accurate than preoperative ultrasound. 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The use of preoperative lymphoscintigraphy and intraoperative gamma probe detection to localize the sentinel lymph node in papillary thyroid carcinoma was investigated. Methods From February 2004 to December 2005 the sentinel lymph node technique was studied in 64 consecutive patients with cytological evidence of papillary thyroid carcinoma. The day before surgery, patients were submitted to US-guided peri-tumoural injection of the radiotracer and a lymphoscintigraphy was performed. In the operating room a total thyroidectomy was done, and thanks to a hand-held gamma probe the sentinel lymph node and all lymph nodes, belonging to the sentinel node compartment, were removed. Results The gamma probe identified the sentinel lymph node in 62 patients (96.8%). We found 48 (77.5%) sentinel lymph node without metastases; 12 (19.3%) with metastases and 2 (3.2%) with micrometastases. In 7 cases (11.3%), with a negative sentinel lymph node, metastases in other nodes of the same region were recorded. In 22 cases (34.3%) the ultrasound give an erroneous indication ( P = 0.004). Five patients (8.0%), 4 with multifocal cancer, had a positive postoperative lymphoscintigraphy. Conclusion This study shows that the sentinel lymph node technique for papillary thyroid carcinoma is feasible, repeatable, and more accurate than preoperative ultrasound. In cases of multifocal thyroid lesions more patients should be enrolled to establish the utility of the radio-guided technique.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>17344018</pmid><doi>10.1016/j.ejso.2007.01.025</doi><tpages>6</tpages></addata></record>
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identifier ISSN: 0748-7983
ispartof European journal of surgical oncology, 2007-11, Vol.33 (9), p.1075-1080
issn 0748-7983
1532-2157
language eng
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source ScienceDirect Journals
subjects Adult
Aged
Aged, 80 and over
Carcinoma, Papillary - diagnostic imaging
Carcinoma, Papillary - secondary
Carcinoma, Papillary - surgery
Female
Gamma Rays
Hematology, Oncology and Palliative Medicine
Humans
Laterocervical lymphoadenectomy
Lymph Node Excision
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Middle Aged
Neck
Papillary thyroid carcinoma
Preoperative Care
Radionuclide Imaging
Sentinel lymph node
Sentinel Lymph Node Biopsy - methods
Surgery
Thyroid Neoplasms - diagnostic imaging
Thyroid Neoplasms - surgery
Thyroidectomy
Ultrasonography
title Use of preoperative lymphoscintigraphy and intraoperative gamma-probe detection for identification of the sentinel lymph node in patients with papillary thyroid carcinoma
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