Browse > Article

The Analysis of Central Cervical Lymph Nodes in Papillary Thyroid Carcinoma with Preoperative No Lymph Node Metastasis  

Kim, Yun-Jung (Department of Surgery, Busan Paik Hospital, Inje University College of Medicine)
Ha, Tae-Kwun (Department of Surgery, Busan Paik Hospital, Inje University College of Medicine)
Ryu, Sung-Mock (Department of Surgery, Busan Paik Hospital, Inje University College of Medicine)
Kim, Sang-Hyo (Department of Surgery, Busan Paik Hospital, Inje University College of Medicine)
Publication Information
Korean Journal of Head & Neck Oncology / v.26, no.2, 2010 , pp. 183-186 More about this Journal
Abstract
Purpose : Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods : A retrospective review was carried out in 394 patients with PTC who underwent surgery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results : The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion : Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.
Keywords
Papillary thyroid carcinoma; Central cervical lymph node; Lymph node dissection;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Ito Y, Tomoda C, Uruno T. Clinical significance of metastasis to the central compartment from papillary microcarcinoma of the thyroid. World J Surg. 2006;30:91-99.   DOI   ScienceOn
2 Pereira JA, Jimeno J, Miquel J, Iglesias M, Munne A, Sancho JJ, et al. Nodal yield, morbidity, and recurrence after central neck dissection for papillary thyroid carcinoma. Surgery. 2005;138: 1095-1100.   DOI   ScienceOn
3 Watkinson JC, Franklyn JA, Olliff JF. Detection and surgical treatment of cervical lymph nodes in differentiated thyroid cancer. Thyroid. 2006;16:187-194.   DOI   ScienceOn
4 Loh K, Green span FS, Gee L. Pathological tumor node metastasis( pTNM) staging of papillary and follicular thyroid carcinomas: Retrospective analysis of 700 patients. J Clin Endo-crinol Metab. 1997;82:3553-3562.   DOI   ScienceOn
5 Mazzaferri EL. A vision for the surgical management of papillary thyroid carcinoma: extensive lymph node compartmental dissections and selective use of radioiodine. J Clin Endocrinol Metab. 2009;94:1086-1088.   DOI   ScienceOn
6 Park HL, Kwak JK, Kang SS, Kim DY, Kang HG, Shin JY, et al. The analysis of tumor aggressiveness according to tumor size in occult papillary thyroid carcinoma. J Korean Surg Soc. 2007;73 (6):470-475.
7 Kasai N, Sakamoto A. New subgrouping of small thyroid carcinomas. Cancer. 1987;60(8):1767-1770.   DOI   ScienceOn
8 Appetecchia M, Scarcello G, Pucci E, Procaccini A. Outcome after treatment of papillary thyroid microcarcinoma. J Exp Clin Cancer Res. 2002;21(2):159-164.
9 Marshall CL, LEE JE, Xing Y, Perrier ND, Edeiken BS, Evans DB, et al. Routine pre-operative Ultrasonography for papillary thyroid cancer: effects on cervical recurrence. Surgery. 2009;146: 1063-1072.   DOI   ScienceOn
10 Sugitani I, Fujimoto Y, Yamada K, Yamamoto N. Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 2008;32: 2494-2502.   DOI   ScienceOn
11 Machens A, Hinze R, Thomusch O, Dralle H. Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg. 2002;26:22-28.   DOI   ScienceOn
12 Kouvaraki MA, Shapiro SE, Fornage BD. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003;134:946-954.   DOI   ScienceOn
13 Wada N, Duh QY, Sugino K. Lymph node metastasis from 259 papillary thyroid microcarcinoma: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg. 2003;237:399-407.
14 Mirallie E, Visset J, Sagan C, Hamy A, Le Bodic MF, Paineau J. Localization of cervical node metastasis of papillary thyroid carcinoma. World J Surg. 1999;23:970-973.   DOI   ScienceOn
15 Caron NR, Clark OH. Well differentiated thyroid cancer. Scand J Surg. 2004;93:261-271.   DOI