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Level V lymph node metastasis in N1b papillary thyroid carcinoma patients: contributing factors and pattern of metastasis

Authors
 Zeng Z. YAP  ;  Won W. KIM  ;  Sang-Wook KANG  ;  Cho R. LEE  ;  Jandee LEE  ;  Jong J. JEONG  ;  Kee-Hyun NAM  ;  Woong Y. CHUNG 
Citation
 CHIRURGIA, Vol.32(3) : 128-132, 2019 
Journal Title
 CHIRURGIA 
ISSN
 1221-9118 
Issue Date
2019
Keywords
Thyroid cancer, papillary ; Neck dissection ; Neoplasm metastasis ; Accessory nerve
Abstract
BACKGROUND: The optimal extent of lateral neck dissection for metastatic differentiated thyroid carcinoma remains controversial given varying evidence of level V metastasis and the morbidity associated with dissection at this level. The aim of this study was to document the pattern of lateral neck metastasis and to identify risk factors contributing to level V lymph node (LN) metastasis. METHODS: A retrospective study of 396 N1b papillary thyroid cancer (PTC) patients who had undergone bilateral total thyroidectomy and lateral neck dissection at our institution between January 2009 and April 2012 was performed. RESULTS: LN metastasis was most frequent at level III (68.4%), followed by level IV (64.6%), level II (62.1%) and level V (11.95%). Multivariate analysis showed that only greater than five metastatic LNs was significantly associated with the presence of level V metastasis. The prevalence of level V metastasis was only 4.1% amongst patients with less than five metastatic LNs. The presence of level V metastasis was also associated with more overall involved nodes (24.9±15.6% vs. 14.9±11.1%, P=0.001). CONCLUSIONS: Level V nodal metastasis in PTC is uncommon and the omission of level V dissection should be considered, especially when only a single node or level metastasis is suspected. However, there is a strong indication to include level V in the lateral neck dissection when multiple LNs are present.
Full Text
https://www.minervamedica.it/en/journals/chirurgia/article.php?cod=R20Y2019N03A0128
DOI
10.23736/S0394-9508.18.04843-X
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Kim, Won Woong(김원웅)
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Lee, Jan Dee(이잔디) ORCID logo https://orcid.org/0000-0003-4090-0049
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175178
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