Summary of doctoral dissertation: Research on the value of sentinel lymph node biopsy in thyroid cance

Comment on the results of the method of visualization and sentinel lymph node biopsy in thyroid carcinoma by Methylene blue in Hanoi Medical University Hospital from 11/2014 to 9/2018 and analyze the some factors affecting the results of method. Evaluate the value of sentinel lymph node biopsy in the diagnosis of occult cervical lymph node metastasis.
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Summary of doctoral dissertation: Research on the value of sentinel lymph node biopsy in thyroid cance MINISTRY OF EDUCATION MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY  NGUYEN XUAN HAU RESEARCH THE VALUE OF SENTINEL LYMPH NODE BIOPSY IN THYROID CARCINOMA Specialization :Oncology Code : 62720149 SUMMARY OF DOCTORAL DISSERTATION HANOI - 2019 THIS STUDY WAS COMPLETED IN: HANOI MEDICAL UNIVERSITY Spervisor: Assoc. Prof. MD. Le Van Quang Reviewer 1:Assoc. Prof. MD. Le Ngoc Ha Reviewer 2:Assoc. Prof. MD. Ngo Thanh Tung Reviewer 3:Assoc. Prof. MD. Le Trung Tho The thesis will be defended before the Examining Board at university level in Hanoi Medical University At …….. o’clock……… Date ……. Month ……. Year… This thesis could be found at - National Library - Centre Medical Information Library LIST OF PUBLICATION RELATED TO THE DISSERTATION 1. Nguyen Xuan Hau, Tran Thi Hau, Le Thi Hang (2017). Clinical, subclinical characteristics and histopathology of early thyroid cancer at Hanoi Medical University Hospital. Vietnam Medical Journal, Number 1, volume 456. 2. Nguyen Xuan Hau, Le Van Quang, Duong Chi Thanh (2017). The result of visualization of sentinel lymph node biopsy with Methylene Blue in thyroid carcinoma. Vietnam Medical Journal, Number 2, volume 456. 3. Nguyen Xuan Hau and Le Van Quang (2018). The role of sentinel lymph node biopsy in thyroid carcinoma and the factors affecting the value of the method. Vietnam Medical Journal, Number 2, volume 472. 4. Le Van Quang, Nguyen Van Hieu, Nguyen Xuan Hau, Nguyen Van Hung (2018). Role of sentinel lymph node biopsy in papillary thyroid carcinoma in Vietnam. International Journal of Hematology and Oncology, number 4, Volume 28. 1 INTRODUCTION 1. Reason to choose the thesis. Thyroid cancer is the most common disease in endocrine cancer, accounting for 3.6% of all cancers in general. Surgery is the most important treatment in thyroid cancer. Thyroidectomy plus lymphadenectomy increase the rate of complications after surgery, but the disease recurrent mainly in cervical lymph node and lymphadenectomy is the first priority choice. Surgery to remove central lymph node in recurrent thyroid cancer increase the risk of complications such as paralysis of the recurrent laryngeal nerve and hypoparathyroidism. To limit systemic cervical lymph node dissection, finding a method to detect occult lymph node metastasis is necessary to determine the treatment strategy. Sentinel lymph node is defined as the first lymph node in the lymphatic drainage area to be drained from the primary tumor, which reflects the condition of the remaining lymph nodes with or without lymph node. This result contributes to the detection of metastatic lymph nodes that are smaller than 2-3 mm in diameter - difficult to detect by other techniques such as high resolution ultrasound. In the world, there have been many studies on the sentinel lymph node of thyroid cancer, however, there has not been any research in this field in Vietnam. Therefore, we carried out the thesis: Research on the value of sentinel lymph node biopsy in thyroid cancer with the following two objectives: 1. Comment on the results of the method of visualization and sentinel lymph node biopsy in thyroid carcinoma by Methylene blue in Hanoi Medical University Hospital from 11/2014 to 9/2018 and analyze the some factors affecting the results of method. 2. Evaluate the value of sentinel lymph node biopsy in the diagnosis of occult cervical lymph node metastasis. 2. New finding of the thesis: - This is the first study in Vietnam, using Methylene Blue to detect sentinel lymph node in thyroid cancer, to help determine the exact occult lymph node metastasis, thereby giving a strategy the cervical 2 lymph node dissection with the same time reasonable thyroidectomy. - The rate of sentinel lymph node detection with Methylene Blue is very high: 98.2%; Most lymph nodes are in the pre-tracheal group (group 6): 90.4%. - Percentage of non-metastatic lymph nodes on pathology: 55.7%; metastasis on pathology: 44.3%, the rate of occult cervical lymph node metastasis is very high: 51.5%. - Sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy and false negative rate of the method are: 86%, 100%, 100%, 87,1%, 92.8% and 14% respectively. 3. The structure of the thesis: The thesis conclude 122 pages, with 4 main chapters: Introduction 2 pages, Chapter 1 (Overview) 40 pages, Chapter 2 (Subjects and Research Methods) 18 pages, Chapter 3 (Research results) 29 pages , Chapter 4 (Discussion) 30 pages, Conclusion and Recommendations 3 pages. The thesis has 33 tables, 7 pictures and 5 charts, 155 references (26 Vietnamese references, 129 English references). Chapter 1: OVERVIEW 1.1. Introduction Sentinel lymph node is defined as the first lymph node in the lymph nodes receiving lymph nodes from primary tumors. Since the past 19 years, approved sentinel lymph node biopsy is a technique to determine the metastatic presence of melanoma cancer and early breast cancer. Recently, sentinel lymph node biopsy has been proposed for use in other cancers, including thyroid cancer. The role of this method is being clarified by the authors. The results of lymph node biopsy help the surgeon make a decision right away in terms of regional lymphadenopathy and appropriate management or systemic behavior. 1.2. Sentinel lymph node biopsy in thyroid carcinoma. 1.2.1. Technology 3 B ...