Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?

World Journal of Surgical Oncology

Wen-Kuan Chen²  Ya-Qi Mu¹  De-Bin Xu³  Dan Liu⁴  Xiao-Jun Zhang² 

[1] Department of Oncology, The First People’s Hospital of Kaifeng, 85 Hedao Street, Kaifeng 475000, P. R. China;Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou 510060, P. R. China;Department of Thyroid Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang 330000, P.R. China;Department of General Surgery, The Fifth People’s Hospital of Shenzhen, 47 Youyi Road, Shenzhen 518000, P. R. China

关键词: Lateral neck dissection;    Lymph node metastasis;    Papillary thyroid carcinoma;   

Others  :  820773
DOI  :  10.1186/1477-7819-11-304

 received in 2013-06-26, accepted in 2013-11-17,  发布年份 2013

【 摘 要 】

Background

The study was designed to explore the regular patterns of level V lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC), and to indicate whether level V should be included in the management of lateral neck dissection when treating PTC.

Methods

This retrospective study consisted of 330 patients diagnosed with PTC from January 1994 to July 2009 who underwent an operation that included therapeutic lateral neck dissection (levels II to V). The patterns of lateral neck LNM were analyzed and the relevant risk factors of level V LNM were analyzed with univariate and multivariate analysis, respectively.

Results

All the patients underwent lateral neck dissection at levels II to V. The predominant site of metastasis was level III (247/330 (74.8%)), followed by level IV (233/330 (70.6%)), and level II (215/330 (65.3%)). Simultaneous multilevel involvement (level II, III, and IV) of lymphatic metastases presented in 46.1% (152/330) of the cases. Level V showed 28.8% (95/330) of nodal metastasis. Multivariate analysis showed that level V LNM was significantly associated with location (whole thyroid), gross extrathyroidal extension and simultaneous multilevel involvement (level II, III and IV). (P <0.05).

Conclusions

Due to relatively high rate of level V involvement and its correlation with location (whole thyroid), gross extrathyroidal extension and multilevel involvement, we consider that it may be more rational to include level V in the therapeutic lateral neck dissection when treating PTC, especially for those who have any one of these three independent risk factors.

【 授权许可】

   
2013 Zhang et al.; licensee BioMed Central Ltd.

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