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Solitary lateral neck node metastasis in papillary thyroid carcinoma

Authors
 Seok-Mo Kim  ;  Ki Won Chun  ;  Ho Jin Chang  ;  Bup-Woo Kim  ;  Yong Sang Lee  ;  Hang-Seok Chang  ;  Cheong Soo Park 
Citation
 WORLD JOURNAL OF SURGICAL ONCOLOGY, Vol.12(1) : 109, 2014 
Journal Title
 WORLD JOURNAL OF SURGICAL ONCOLOGY 
Issue Date
2014
MeSH
Animals ; Bone Morphogenetic Protein 2/genetics ; Bone Morphogenetic Protein 2/pharmacology ; Bone Morphogenetic Protein Receptors, Type I/genetics* ; Epithelium/metabolism ; Gene Expression Regulation/genetics* ; Genetic Vectors/genetics ; Lentivirus/genetics ; Male ; Mesoderm/metabolism ; Mice ; Mice, Nude ; MicroRNAs/antagonists & inhibitors ; MicroRNAs/genetics* ; Odontogenesis/genetics* ; Recombinant Proteins/pharmacology ; Signal Transduction/genetics* ; Tooth Germ/drug effects ; Tooth Germ/metabolism ; Tooth Germ/transplantation ; Transcription, Genetic/genetics ; Transforming Growth Factor beta/Adolescent ; Adult ; Aged ; Carcinoma, Papillary/secondary* ; Carcinoma, Papillary/surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes/pathology* ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection/methods* ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; ROC Curve ; Retrospective Studies ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Thyroidectomy* ; Young Adultmacology ; Substances
Keywords
thyroid ; papillary ; solitary ; metastasis
Abstract
BACKGROUND: Papillary thyroid carcinoma (PTC) is associated with a high incidence of regional node metastasis, but the patterns of lateral neck node metastasis (LNM) vary. Occasionally, a solitary LNM (SLNM) is seen in PTC patients. We therefore assessed whether selective single level node dissection is appropriate in PTC patients with SLNM. METHODS: We retrospectively reviewed the medical records of 241 PTC patients who underwent total thyroidectomy with central neck dissection plus ipsilateral internal jugular node dissection (level II to IV) between January 2010 and December 2011. Of these patients, 51 had SLNM and 190 had multiple LNM (MLNM). The clinicopathologic characteristics of the two groups were compared. RESULTS: Age, gender ratio, and numbers of lateral neck nodes harvested (29.4±11.0 versus 30.3±9.5; P=0.574) were similar in the SLNM and MLNM groups. Mean primary tumor size was significantly smaller in the SLNM than in the MNLM group (1.03 cm versus 1.35 cm; P=0.037). The proportion of patients with primary tumor≤1 cm was significantly greater in the SLNM group (60.8% versus 38.4%; P=0.006), whereas the proportion with maximal node size≤0.7 cm (28.9% versus 73.3%; P<0.001) and the proportion with capsular invasion (62.7% versus 83.7%, P=0.002) were significantly lower in the SLNM than in the MLNM group. CONCLUSIONS: Selective single level neck dissection can be considered as an alternative to systemic lateral neck dissection in PTC patients with SLNM, maximal metastatic node size≤0.7 cm, and no extrathyroidal invasion.
Files in This Item:
T201401359.pdf Download
DOI
10.1186/1477-7819-12-109
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bup Woo(김법우) ORCID logo https://orcid.org/0000-0002-1342-9055
Kim, Seok Mo(김석모) ORCID logo https://orcid.org/0000-0001-8070-0573
Park, Cheong Soo(박정수)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Chang, Ho Jin(장호진) ORCID logo https://orcid.org/0000-0002-8940-3484
Chun, Ki Won(전기원)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98725
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