Journal of Surgery Concepts & Practice >

2021 , Vol. 26 >Issue 02: 159 - 162

DOI: https://doi.org/10.16139/j.1007-9610.2021.02.013

Original article

Characteristics of central compartment lymph node metastasis in patients with unilateral cN0 papillary thyroid carcinoma and prophylactic dissection

Expand
  • Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Received date: 2020-02-26

  Online published: 2022-07-27

Fold

Abstract

Objective To study the central compartment lymph node (CLN) metastasis in patients with unilateral pa-pillary thyroid carcinoma(PTC) diagnosed preoperatively and prophylactic dissection. Methods The data of 342 patients with unilateral PTC at cN0 stage who underwent unilateral thyroidectomy, isthmusectomy and prophylactic CLN dissection were analyzed retrospectively in our department from January 2016 to December 2018. The characteristics of CLN metastasis were analyzed. Results Among 342 patients, 188(55.0%) patients had CLN metastasis. CLN metastasis was significantly related with age (P<0.001), sex (P<0.001), maximum diameter of tumor (P=0.001), capsular invasion (P=0.046), and more CLN (P<0.001). Metastatic CLN density is the metastatic CLN%, which was significantly related with sex (P=0.023) and capsular invasion (P=0.004). There was only one case with cervical hematoma and reoperation among all cases in this study. Two cases had temporary recurrent laryngeal nerve paralysis. Conclusions CLN metastasis in unilateral cN0 PTC patients was characterized with relation to sex, age, and lymph node density. Therefore prophylactic CLN dissection is necessary and safe for unilateral cN0 PTC patients.

Key words： Papillary thyroid carcinoma; Central compartment lymph node metastasis; Metastatic lymph node density; BRAF V600E

Cite this article

LIU Wei, WANG Cong, XUE Anwei, ZHAO Junjie, WANG Zhenglin . Characteristics of central compartment lymph node metastasis in patients with unilateral cN0 papillary thyroid carcinoma and prophylactic dissection[J]. Journal of Surgery Concepts & Practice, 2021 , 26(02) : 159 -162 . DOI: 10.16139/j.1007-9610.2021.02.013

References

[1] Haugen BR, Alexander EK, Bible KC, et al. 2015 Ame-rican Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2016, 26(1):1-133.
[2] 沈晓卉, 吕春晖, 陈海珍, 等. 甲状腺癌中央区淋巴结清扫和术后甲状旁腺功能减退[J]. 外科理论与实践, 2016, 21(4):312-317.
[3] Moley JF, Lairmore TC, Doherty GM, et al. Preservation of the recurrent laryngeal nerves in thyroid and parathyroid reoperations[J]. Surgery, 1999, 126(4):673-677;discussion 677-679.
[4] Ito Y, Jikuzono T, Higashiyama T, et al. Clinical significance of lymph node metastasis of thyroid papillary carcinoma located in one lobe[J]. World J Surg, 2006, 30(10):1821-1828.
[5] 郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志, 2019, 41(1):19-28.
[6] 王卓颖. 规范的甲状腺癌颈部淋巴结清扫是降低复发的关键[J]. 外科理论与实践, 2016, 21(4):300-302.
[7] Zhao WJ, Luo H, Zhou YM, et al. Evaluating the effectiveness of prophylactic central neck dissection with total thyroidectomy for cN0 papillary thyroid carcinoma: an updated meta-analysis[J]. Eur J Surg Oncol, 2017, 43(11):1989-2000.
[8] Zhang L, Wei WJ, Ji QH, et al. Risk factors for neck nodal metastasis in papillary thyroid microcarcinoma: a study of 1066 patients[J]. J Clin Endocrinol Metab, 2012, 97(4):1250-1257.
[9] 卢秀波. 甲状腺乳头状癌中央区及颈侧区淋巴结转移相关因素探讨[J]. 中国实用外科杂志, 2017, 37(9):952-955.
[10] 沈晓卉, 丁家增, 陈海珍, 等. 甲状腺再次手术分析(附110例报告)[J]. 外科理论与实践, 2019, 24(1):79-84.
[11] Ito Y, Fukushima M, Higashiyama T, et al. Incidence and predictors of right paraesophageal lymph node metastasis of N0 papillary thyroid carcinoma located in the right lobe[J]. Endocr J, 2013, 60(3):389-392.
[12] 董云伟. 合并慢性淋巴细胞性甲状腺炎的甲状腺乳头状癌的临床病理特点及淋巴结转移的风险分析[D]. 山西医科大学, 2017.
[13] Mathur A, Moses W, Rahbari R, et al. Higher rate of BRAF mutation in papillary thyroid cancer over time: a single-institution study[J]. Cancer, 2011, 117(19):4390-4395.
[14] 王越. 桥本氏甲状腺炎合并PTC临床病理特征与BRAF V600E基因突变的相关性研究[D]. 青岛大学, 2019.
[15] Hwang JE, Kim H, Shim HJ, et al. Lymph-node ratio is an important clinical determinant for selecting the appropriate adjuvant chemotherapy regimen for curative D2-resected gastric cancer[J]. J Cancer Res Clin Oncol, 2019, 145(8):2157-2166.
Options
Outlines

/

〈 〉