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Is the Internal Jugular Node Dissection without Level V Sufficient in Patients with Papillary Thyroid Carcinoma with Lateral Neck Node Metastasis?

 Cho Rok Lee  ;  Jin Kyong Kim  ;  Sang-Wook Kang  ;  Jandee Lee  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Woong Youn Chung 
 Korean journal of Endocrine Surgery (대한내분비외과학회지), Vol.20(3) : 31-40, 2020-09 
Journal Title
 Korean journal of Endocrine Surgery (대한내분비외과학회지) 
Issue Date
Thyroid carcinoma ; Neck dissection ; Recurrence
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.
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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, Jin Kyong(김진경)
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
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