BACKGROUND: At the time of diagnosis, 30-60% of patients with papillary thyroid cancer (PTC) exhibit lymph node involvement in the lateral neck compartment (LNC), which significantly impacts their prognosis by increasing the risk of disease recurrence.

METHODS: From June 2012 to December 2016, 154 patients without lateral nodal involvement underwent total thyroidectomy and central compartment neck dissection. During the procedure, 0.2 ml of Patent Blue dye was applied in the upper half of the thyroid gland, which allowed the identification of lymphatic drainage in the LNC. Subsequently, 2-3 sentinel lymph nodes (SLN) were removed for frozen section analysis (Group 1). If metastatic involvement was detected, lateral neck dissection was performed. The reference groups consisted of patients without detected lymphatic drainage (Group 2) and patients who underwent LNC dissection due to preoperatively detected lymph node metastases (Group 3). The study evaluated the biochemical, structural, and overall persistence of the disease at the time of adjuvant radioiodine ablation administration.

RESULTS: The SLN identification rate in the study was 95.45%. In Group 1, out of the total 32 patients with a positive SLN, 24 patients had a positive SLN based on frozen section analysis, while 8 patients had the positive diagnosis confirmed through definitive histology. Group 1 showed better outcomes in terms of disease persistence, with significantly lower reoperation rates compared to Groups 2 and 3 (2.04% vs. 6.94% and 45.45%, respectively).

CONCLUSION: This method enables accurate identification of previously undetected lymph node metastases in the LNC, aiding surgical treatment for PTC patients.