Asian Pacific Journal of Cancer Prevention

  • 제13권9호
  • /
  • Pages.4619-4622
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  • 2012
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  • 1513-7368(pISSN)
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  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
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Is Level V Dissection Necessary for Low-risk Patients with Papillary Thyroid Cancer Metastasis in Lateral Neck Levels II, III, and IV

  • Yu, Wen-Bin (Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck, Peking University Cancer Hospital & Institute) ;
  • Tao, Song-Yun (Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck, Peking University Cancer Hospital & Institute) ;
  • Zhang, Nai-Song (Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck, Peking University Cancer Hospital & Institute)
  • 발행 : 2012.09.30
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초록

Whether it is beneficial to dissect level V in papillary thyroid cancer (PTC) patients with positive lateral neck lymph nodes at levels II-IV is still controversial, especially for low risk cases. In this study, we reviewed the medical records of 47 patients who underwent 47 ipsilateral selective lateral neck dissections (levels II-IV) for previously untreated papillary thyroid carcinomas between October 2006 and October 2008 to assist in establishing the optimal strategy for lateral neck dissection in low risk PTC patients with clinically negative level V nodes. All 47 patients were confirmed to have positive lymph nodes pathologically. Seventeen (36.12%), 36 (76.6%), and 34 (72.34%) patients had positive lymph nodes in levels II, III, and IV, respectively. The mean number of pathologically positive lymph nodes was 1.7 in level II, 2.9 in level III, 2.8 in level IV. No death and distant metastasis were recorded during follow up period. Just 2 patients exhibited recurrence to lymph nodes, and only one showed nodal recurrence in ipsilateral level V, who had positive lymph nodes in all of levels II, III, and IV at initial neck surgery. In conclusion, for PTC low risk patients with clinically negative lymph nodes in level V, non-performance of level V dissection would still achieve good survival results as traditional modified radical neck dissection, with a "wait and see" strategy to be recommended.

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참고문헌

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피인용 문헌

  1. Comparison of Presentation and Clinical Outcome between Children and Young Adults with Differentiated Thyroid Cancer vol.15, pp.17, 2014, https://doi.org/10.7314/APJCP.2014.15.17.7271
  2. Prophylactic Level VII Nodal Dissection as a Prognostic Factor in Papillary Thyroid Carcinoma: a Pilot Study of 27 Patients vol.16, pp.10, 2015, https://doi.org/10.7314/APJCP.2015.16.10.4211
  3. Patterns, predictive factors and prognostic impact of multilevel metastasis in N1b papillary thyroid carcinoma vol.104, pp.7, 2017, https://doi.org/10.1002/bjs.10514
  4. Should Level V Be Routinely Dissected in N1b Papillary Thyroid Carcinoma? vol.27, pp.2, 2017, https://doi.org/10.1089/thy.2016.0364
  5. Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection vol.46, pp.1, 2017, https://doi.org/10.1186/s40463-017-0221-3