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Tytuł:
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Relevance of level IIb neck dissection in patients with papillary thyroid carcinoma.
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Autorzy:
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Hosokawa S; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
Takahashi G; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.; Yamahoshi ENT Clinic, Hamamatsu, Japan.
Okamura J; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.; Department of Otorhinolaryngology, Seirei Hamamatsu General Hospital, Japan.
Imai A; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
Mochizuki D; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
Ishikawa R; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
Takizawa Y; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
Misawa K; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
Shinmura K; Department of Tumor Pathology, Hamamatsu University School of Medicine, Japan.
Mineta H; Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan.
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Źródło:
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The Journal of laryngology and otology [J Laryngol Otol] 2021 Mar; Vol. 135 (3), pp. 269-272. Date of Electronic Publication: 2021 Feb 23.
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Typ publikacji:
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Journal Article; Observational Study
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Język:
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English
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Imprint Name(s):
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Publication: Cambridge : Cambridge University Press
Original Publication: London : Headley Brothers,
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MeSH Terms:
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Lymphatic Metastasis/*diagnosis
Neck Dissection/*methods
Thyroid Cancer, Papillary/*pathology
Thyroid Neoplasms/*pathology
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Male ; Middle Aged ; Neck/pathology ; Neck/surgery ; Preoperative Period ; Prognosis ; Retrospective Studies ; Thyroid Cancer, Papillary/surgery ; Thyroid Neoplasms/surgery ; Treatment Outcome ; Young Adult
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Contributed Indexing:
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Keywords: Accessory Nerve; Lymph Nodes; Lymphatic Metastasis; Neck Dissection; Thyroid Neoplasms
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Entry Date(s):
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Date Created: 20210223 Date Completed: 20210330 Latest Revision: 20210330
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Update Code:
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20240105
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DOI:
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10.1017/S0022215121000499
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PMID:
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33618782
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Background: Cervical nodal metastasis is a key prognostic factor in patients with papillary thyroid carcinoma. The role of lymph nodes in papillary thyroid carcinoma management and prognosis remains controversial.
Methods: Level IIb lymph nodes obtained from 44 patients with papillary thyroid carcinoma were histopathologically examined retrospectively. Specimens were classified as ipsilateral or contralateral. The number of dissected nodes and prevalence of level IIb metastasis were compared according to pre-operative clinical nodal stage.
Results: In the node-negative neck, the prevalence of contralateral and ipsilateral IIb nodes was 0 out of 20 and 0 out of 3, respectively. In the node-positive neck, the prevalence of contralateral and ipsilateral IIb nodes was 1 out of 13 (7.70 per cent) and 3 out of 41 (7.32 per cent), respectively. Clinically determined and pathologically confirmed level IIb node negativity were significantly associated. Thirty-four patients (77.3 per cent) developed accessory nerve complications from level IIb dissection.
Conclusion: Level IIb neck dissection for papillary thyroid carcinoma may be required if pre-operative examination reveals multilevel, level IIa or suspicious level IIb metastasis.
