![]() 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. According to this data, SLN involvement is an accurate predictor of central compartment metastasis, however surgeons should use caution when relying on intraoperative frozen section to determine whether to perform a CCND. Finally, this study shows that 23.3% of positive SLN’s were false negatives on intraoperative frozen section. Moreover, when the SLN’s are negative for metastasis on frozen section, the central compartment was disease-free in 94.4% of cases. This data series demonstrates that patients with WDTC have positive SLN’s in 14.3% of cases. On frozen section analysis, the sensitivity, specificity, positive predictive value and negative predictive value (95% CI) of our SLN biopsy technique aiming to remove all disease from the central compartment was 68.8% (53.6-80.9), 100% (98.1-100), 100% (87.0-100) and 94.4% (90.7-96.7) respectively with P < 0.0001. Frozen section results failed in predicting central compartment involvement in 15 cases (5%) whereas central neck compartment involvement was missed in 5 cases (1.7%) when based on permanent section results. Of this, 11% (33/300) were positive on intraoperative frozen section analysis. SLN’s with metastasis were found in 14.3% (43/300) of cases. Both frozen and permanent section analyses were performed. ![]() Lymph nodes staining blue were considered as SLN’s. A limited pretracheal central compartment neck dissection (CCND) was performed on all patients. The SLN biopsy protocol using 1% methylene blue was performed in 300 patients undergoing thyroidectomy for WDTC. The aim of this study is to prospectively review the role of sentinel lymph node (SLN) biopsy in the management of well differentiated thyroid carcinoma (WDTC), and to determine the efficacy of intraoperative frozen section analysis at detecting SLN metastasis and central compartment involvement.
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