Is the Internal Jugular Node Dissection without Level V Sufficient in Patients with Papillary Thyroid Carcinoma with Lateral Neck Node Metastasis?
Purpose: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, and completeness of surgical resection is an important determinant of outcomes. The appropriate extent of therapeutic lateral neck dissection remains controversial. This study aims to access the impact of lat...
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| Published in | Journal of endocrine surgery Vol. 20; no. 3; pp. 31 - 40 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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대한내분비외과학회
01.09.2020
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| ISSN | 2508-8149 2508-8459 2508-8459 |
| DOI | 10.16956/jes.2020.20.3.31 |
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| Abstract | Purpose: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, and completeness of surgical resection is an important determinant of outcomes. The appropriate extent of therapeutic lateral neck dissection remains controversial. This study aims to access the impact of lateral neck node dissection of levels II to V in a large patient series.
Methods: A retrospective review of the clinical charts and hospital records of 778 consecutive patients who had metastatic PTC and who underwent unilateral cervical lymph node dissection at a single institution between 1999 January and 2009 December.
Results: A total of 489 modified radical neck dissection (MRND) (levels II–V) and 289 internal jugular node dissection (IJND) (levels II–IV) were performed in 778 patients. There were no differences in clinicopathological findings except for the retrieved and metastatic lateral lymph nodes (LLNs). The multiple-level lymph node (LN) metastasis was more prevalent in the MRND group, and the distribution of metastasis lymph node levels was significantly different in both group. The recurrence rate and disease-free survival were similar in the 2 groups. In multivariate analysis, female sex, tumor size, and multi-level LLN metastasis were independent predictors recurrence. Postoperative complications were similar in MRND and IJND group.
Conclusion: IJND achieves favorable postoperative results in PTC with lateral neck node metastasis patients, and level V metastasis/recurrence incidence is low. Therefore, the extent of lateral neck node dissection, whether IJND or MRND, can be considered for patients according to the simultaneous metastasis level and the tumor size. KCI Citation Count: 0 |
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| AbstractList | Purpose: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, and completeness of surgical resection is an important determinant of outcomes. The appropriate extent of therapeutic lateral neck dissection remains controversial. This study aims to access the impact of lateral neck node dissection of levels II to V in a large patient series.
Methods: A retrospective review of the clinical charts and hospital records of 778 consecutive patients who had metastatic PTC and who underwent unilateral cervical lymph node dissection at a single institution between 1999 January and 2009 December.
Results: A total of 489 modified radical neck dissection (MRND) (levels II–V) and 289 internal jugular node dissection (IJND) (levels II–IV) were performed in 778 patients. There were no differences in clinicopathological findings except for the retrieved and metastatic lateral lymph nodes (LLNs). The multiple-level lymph node (LN) metastasis was more prevalent in the MRND group, and the distribution of metastasis lymph node levels was significantly different in both group. The recurrence rate and disease-free survival were similar in the 2 groups. In multivariate analysis, female sex, tumor size, and multi-level LLN metastasis were independent predictors recurrence. Postoperative complications were similar in MRND and IJND group.
Conclusion: IJND achieves favorable postoperative results in PTC with lateral neck node metastasis patients, and level V metastasis/recurrence incidence is low. Therefore, the extent of lateral neck node dissection, whether IJND or MRND, can be considered for patients according to the simultaneous metastasis level and the tumor size. KCI Citation Count: 0 |
| Author | Nam, Kee-Hyun Lee, Cho Rok Lee, Jandee Kim, Jin Kyong Kang, Sang-Wook Jeong, Jong Ju Chung, Woong Youn |
| Author_xml | – sequence: 1 givenname: Cho Rok orcidid: 0000-0001-7848-3709 surname: Lee fullname: Lee, Cho Rok organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea – sequence: 2 givenname: Jin Kyong orcidid: 0000-0001-5121-8462 surname: Kim fullname: Kim, Jin Kyong organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea – sequence: 3 givenname: Sang-Wook orcidid: 0000-0001-5355-833X surname: Kang fullname: Kang, Sang-Wook organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea – sequence: 4 givenname: Jandee orcidid: 0000-0003-4090-0049 surname: Lee fullname: Lee, Jandee organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea – sequence: 5 givenname: Jong Ju orcidid: 0000-0002-4155-6035 surname: Jeong fullname: Jeong, Jong Ju organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea – sequence: 6 givenname: Kee-Hyun orcidid: 0000-0002-6852-1190 surname: Nam fullname: Nam, Kee-Hyun organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea – sequence: 7 givenname: Woong Youn orcidid: 0000-0002-0291-8048 surname: Chung fullname: Chung, Woong Youn organization: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea |
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| Title | Is the Internal Jugular Node Dissection without Level V Sufficient in Patients with Papillary Thyroid Carcinoma with Lateral Neck Node Metastasis? |
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