Drawing as a Way of Knowing: How a Mapping Model Assists Preoperative Evaluation of Patients with Thyroid Carcinoma

Author:

Biffoni Marco1ORCID,Grani Giorgio2ORCID,Melcarne Rossella2ORCID,Geronzi Valerio1,Consorti Fabrizio3ORCID,Ruggieri Giuseppe De1,Galvano Alessia1,Razlighi Maryam Hosseinpour1,Iannuzzi Eva1,Engel Tal Deborah1,Pace Daniela4,Di Gioia Cira Rosaria Tiziana5ORCID,Boniardi Marco6,Durante Cosimo2ORCID,Giacomelli Laura1ORCID

Affiliation:

1. Department of General and Specialist Surgery, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy

2. Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy

3. Department of General Surgery, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy

4. Department of Endocrinology, Valmontone Hospital, 00038 Valmontone, Italy

5. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy

6. Endocrine Surgery Unit, Niguarda Hospital, 20162 Milan, Italy

Abstract

Background: Effective pre-surgical planning is crucial for achieving successful outcomes in endocrine surgery: it is essential to provide patients with a personalized plan to minimize operative and postoperative risks. Methods: Preoperative lymph node (LN) mapping is a structured high-resolution ultrasonography examination performed in the presence of two endocrinologists and the operating surgeon before intervention to produce a reliable “anatomical guide”. Our aim was to propose a preoperative complete model that is non-invasive, avoids overdiagnosis of thyroid microcarcinomas, and reduces medical expenses. Results: The use of ‘preoperative echography mapping’ has been shown to be successful, particularly in patients with suspected or confirmed neoplastic malignancy. Regarding prognosis, positive outcomes have been observed both post-surgery and in terms of recurrence rates. We collected data on parameters such as biological sex, age, BMI, and results from cytologic tests performed with needle aspiration, and examined whether these parameters predict tumor malignancy or aggressiveness, calculated using a multivariate analysis (MVA). Conclusions: A standard multidisciplinary approach for evaluating neck lymph nodes pre-operation has proven to be an improved diagnostic and preoperative tool.

Publisher

MDPI AG

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