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Skip Lateral Neck Node Metastases in Papillary Thyroid Carcinoma

 Jae Hyun Park  ;  Yong Sang Lee  ;  Bup Woo Kim  ;  Hang-Seok Chang  ;  Cheong Soo Park 
 World Journal of Surgery, Vol.36(4) : 743-747, 2012 
Journal Title
 World Journal of Surgery 
Issue Date
Background: Papillary thyroid carcinomas (PTCs) are commonly associated with lymph node metastases (LNMs), which are thought to disseminate sequentially, first to the central compartment and later to the lateral compartment. However, a small number of patients have skip metastases to the lateral compartment without central LNMs. This study was performed to evaluate the clinicopathologic characteristics of skip metastases in PTC. METHODS: We reviewed the medical records of 147 patients who underwent total thyroidectomy with central neck dissection plus modified radical neck dissection (RND) for PTC. A single surgeon performed all operations. The patients were classified as either present or absent skip metastases. The clinicopathologic characteristics were statistically analyzed. RESULTS: Skip metastases were found in 32 patients (21.8%) and occurred commonly with primary tumors of the upper pole, and with tumors ≤1 cm in diameter. Skip metastases were less common in patients with multifocal disease. Patients with skip metastases had fewer metastatic lateral nodes that were more frequently found at a single level: mostly at level III (96.9%) and level II (34.4%). CONCLUSIONS: Although skip metastases occur in only a small number of patients, the lateral compartment should be carefully evaluated for skip metastases, even though primary tumors are either single focus, located in the upper pole, or ≤1 cm in diameter.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김법우(Kim, Bup Woo)
박정수(Park, Cheong Soo)
이용상(Lee, Yong Sang)
장항석(Chang, Hang Seok)
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