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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2012

Open Access 01-12-2012 | Research

Optimal surgical extent of lateral and central neck dissection for papillary thyroid carcinoma located in one lobe with clinical lateral lymph node metastasis

Authors: Hyo Sub Keum, Yong Bae Ji, Jong Min Kim, Jin Hyeok Jeong, Woong Hwan Choi, You Hern Ahn, Kyung Tae

Published in: World Journal of Surgical Oncology | Issue 1/2012

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Abstract

Background

The indications and extent of cervical lymph node dissection in papillary thyroid carcinoma (PTC) are still being debated. The aim of this study was to analyze the patterns of cervical lymph node metastasis in the lateral and central compartment and related factors and suggest the optimal extent of lateral and central neck dissection for PTC patients with clinical lateral lymph node metastasis.

Methods

We retrospectively analyzed 72 patients with unilateral PTC who underwent therapeutic lateral neck dissections with concomitant total thyroidectomy and central neck dissection between January 2001 and December 2009.

Results

The 72 patients underwent 79 sides of therapeutic lateral neck dissection. The most frequent metastatic level in the ipsilateral lateral compartment was level IV (75.0%), followed by level III (69.4%), level II (56.9%) and level V (20.8%). Multiple level metastases were common (77.8%) and were correlated with tumor size (≥ 10 mm). The central compartment lymph node metastasis rate was 87.5%, including 26.4% of contralateral central compartment metastases.

Conclusion

In PTC patients with clinical lateral lymph node metastasis, the optimal extent of lateral and central neck dissection should include levels II, III, IV and V as well as the bilateral central compartment.
Literature
1.
Hay ID, Bergstralh EJ, Goellner JR, Ebersold JR, Grant CS: Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery. 1993, 114: 1050-1058.PubMed
2.
Lundgren CI, Hall P, Dickman PW, Zedenius J: Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case–control study. Cancer. 2006, 106: 524-531. 10.1002/cncr.21653.CrossRefPubMed
3.
Hughes CJ, Shaha AR, Shah JP, Loree TR: Impact of lymph node metastasis in differentiated carcinoma of the thyroid: a matched-pair analysis. Head Neck. 1996, 18: 127-132. 10.1002/(SICI)1097-0347(199603/04)18:2<127::AID-HED3>3.0.CO;2-3.CrossRefPubMed
4.
Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM: Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009, 19: 1167-1214. 10.1089/thy.2009.0110.CrossRefPubMed
5.
Sugitani I, Fujimoto Y, Yamada K, Yamamoto N: Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 2008, 32: 2494-2502. 10.1007/s00268-008-9711-9.CrossRefPubMed
6.
Ito Y, Higashiyama T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K, Miyauchi A: Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral node metastasis: validity of prophylactic modified radical neck dissection. World J Surg. 2007, 31: 2085-2091. 10.1007/s00268-007-9224-y.CrossRefPubMed
7.
Bhattacharyya N: Surgical treatment of cervical nodal metastases in patients with papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2003, 129: 1101-1104. 10.1001/archotol.129.10.1101.CrossRefPubMed
8.
Shaha AR: Management of the neck in thyroid cancer. Otolaryngol Clin North Am. 1998, 31: 823-831. 10.1016/S0030-6665(05)70090-6.CrossRefPubMed
9.
Noguchi S, Murakami N: The value of lymph-node dissection in patients with differentiated thyroid cancer. Surg Clin North Am. 1987, 67: 251-261.PubMed
10.
Musacchio MJ, Kim A, Vijungco JD, Prinz RA: Greater local recurrence occurs with “berry picking” than neck dissection in thyroid cancer. Am J Surg. 2003, 69: 191-196.
11.
Roh JL, Kim JM, Park CI: Lateral cervical lymph node metastases from papillary thyroid carcinoma: pattern of nodal metastases and optimal strategy for neck dissection. Ann Surg Oncol. 2008, 15: 1177-1182. 10.1245/s10434-008-9813-5.CrossRefPubMed
12.
Koo BS, Choi EC, Park YH, Kim EH, Lim YC: Occult contralateral central lymph node metastases in papillary thyroid carcinoma with unilateral lymph node metastasis in the lateral neck. J Am Coll Surg. 2010, 210: 895-900. 10.1016/j.jamcollsurg.2010.01.037.CrossRefPubMed
13.
Leboulleux S, Girard E, Rose M, Travagli JP, Sabbah N, Caillou B, Hartl DM, Lassau N, Baudin E, Schlumberger M: Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 2007, 92: 3590-3594. 10.1210/jc.2007-0444.CrossRefPubMed
14.
Som PM, Brandwein M, Lidov M, Lawson W, Biller HF: The varied presentations of papillary thyroid carcinoma cervical nodal disease: CT and MR findings. AJNR Am J Neuroradio. 1994, 15: 1123-1128.
15.
16.
Grodski S, Cornford L, Sywak M, Sidhu S, Delbridge L: Routine level VI lymph node dissection for papillary thyroid cancer: surgical technique. ANZ J Surg. 2007, 77: 203-208. 10.1111/j.1445-2197.2007.04019.x.CrossRefPubMed
17.
Goropoulos A, Karamoshos K, Christodoulou A, Ntitsias T, Paulou K, Samaras A, Xirou P, Efstratiou I: Value of the cervical compartments in the surgical treatment of papillary thyroid carcinoma. World J Surg. 2004, 28: 1275-1281. 10.1007/s00268-004-7643-6.CrossRefPubMed
18.
Machens A, Holzhausen HJ, Dralle H: Skip metastases in thyroid cancer leaping the central lymph node compartment. Arch Surg. 2004, 139: 43-45. 10.1001/archsurg.139.1.43.CrossRefPubMed
19.
Kupferman ME, Weinstock YE, Santillan AA, Mishra A, Roberts D, Clayman GL, Weber RS: Predictors of level V metastasis in well-differentiated thyroid cancer. Head Neck. 2008, 30: 1469-1474. 10.1002/hed.20904.CrossRefPubMed
20.
Pingpank JF, Sasson AR, Hanlon AL, Friedman CD, Ridge JA: Tumor above the spinal accessory nerve in papillary thyroid cancer that involves lateral neck nodes: a common occurrence. Arch Otolaryngol Head Neck Surg. 2002, 128: 1275-1278.CrossRefPubMed
21.
Sivanandan R, Soo KC: Pattern of cervical lymph node metastases from papillary carcinoma of the thyroid. Br J Surg. 2001, 88: 1241-1244. 10.1046/j.0007-1323.2001.01843.x.CrossRefPubMed
22.
Caron NR, Tan YY, Ogilvie JB, Triponez F, Reiff ES, Kebebew E, Duh QY, Clark OH: Selective modified radical neck dissection for papillary thyroid cancer–is level I, II, and V dissection always necessary?. World J Surg. 2006, 30: 833-840. 10.1007/s00268-005-0358-5.CrossRefPubMed
23.
Lim YC, Choi EC, Yoon YH, Koo BS: Occult lymph node metastases in neck level V in papillary thyroid carcinoma. Surgery. 2010, 147: 241-245. 10.1016/j.surg.2009.09.002.CrossRefPubMed
24.
Mulla MG, Knoefel WT, Gilbert J, McGregor A, Schulte KM: Lateral cervical lymph node metastases in papillary thyroid cancer: A systematic review of imaging-guided and prophylactic removal of the lateral compartment. Clin Endocrinol. 2012, 77: 126-131. 10.1111/j.1365-2265.2012.04336.x.CrossRef
25.
Farrag T, Lin F, Brownlee N, Kim M, Sheth S, Tufano RP: Is routine dissection of level II-B and V-A necessary in patients with papillary thyroid cancer undergoing lateral neck dissection for FNA-confirmed metastases in other levels. World J Surg. 2009, 33: 1680-1683. 10.1007/s00268-009-0071-x.CrossRefPubMed
26.
Lee J, Sung TY, Nam KH, Chung WY, Soh EY, Park CS: Is level IIb lymph node dissection always necessary in N1b papillary thyroid carcinoma patients?. World J Surg. 2008, 32: 716-721. 10.1007/s00268-007-9381-z.CrossRefPubMed
27.
Lee BJ, Wang SG, Lee JC, Son SM, Kim IJ, Kim YK: Level IIb lymph node metastasis in neck dissection for papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2007, 133: 1028-1030. 10.1001/archotol.133.10.1028.CrossRefPubMed
Metadata
Title
Optimal surgical extent of lateral and central neck dissection for papillary thyroid carcinoma located in one lobe with clinical lateral lymph node metastasis
Authors
Hyo Sub Keum
Yong Bae Ji
Jong Min Kim
Jin Hyeok Jeong
Woong Hwan Choi
You Hern Ahn
Kyung Tae
Publication date
01-12-2012
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2012
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-10-221

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