유두상 갑상선 암에서 측경부 림프절 전이패턴 및 5구역 전이 예측

김태령; 이영돈; 박흥규; 정유승; 구소령

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자료유형: 학술저널

저자정보: 김태령 이영돈 박흥규 정유승 구소령

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제11권 제3호

발행연도: 2011.1

수록면: 164 - 168 (5page)

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Purpose: Cervical lymphadenectomy is frequently performed in patients with lateral cervical lymph node metastasis to improve regional control of disease. However, there is controversy regarding appropriate levels of the neck that need to be dissected. In particular, the routine dissection of level V remains an annoying and time consuming procedure due to the injury of the spinal accessory nerve. Methods: To identify clinical and pathological predictors of cervical node metastases to level V in papillary thyroid carcinoma, we analyzed 42 patients who underwent modified radical neck dissection (MRND), which were separately performed by each strict anatomical level. Five patients underwent both MRND, 29 patients received total thyroidectomy with central neck node dissection and MRND at the time of initial operation. Thirteen patients underwent MRND later when lateral neck metastases were found at the follow-up after total thyroidectomy with central neck node dissection. Results: In our series, 11.9% of neck specimens harbored metastatic thyroid carcinoma at level V. The metastatic rate of level II, III, and IV was 54.7%, 85.7%, and 64.2%, respectively. The presence of level V metastases was not significantly associated with level II, III metastases, age, sex, and histopathologic findings. But, it seemed to be associated with level IV metastases if the proportion of metastasis of level IV exceeded 50%. Conclusion: Cervical node metastasis seems to be associated with level IV metastases if the proportion of metastasis of level IV exceeds 50%. (Korean J Endocrine Surg 2011;11:164-168)

#유두상 갑상선암 #측경부 림프절 전이 #변형근치적 림프절제술 #5구역 림프절 전이 #Papillary thyroid carcinoma #Lateral neck node metastasis #Modified radical neck node dissection #Level V metastases

참고문헌 (22)

참고문헌 신청

Caron NR / 2005 / Papillary thyroid cancer: surgical management of lymph node metastases / Curr Treat Options Oncol 6 : 311 ~ 322

Caron NR / 2006 / Selective modified radical neck dissection for papillary thyroid cancer-is level I, II and V dissection always necessary? / World J Surg 30 : 833 ~ 840

Cheah WK / 2002 / Complications of neck dissection for thyroid cancer / World J Surg 26 : 1013 ~ 1016

Farrag T / 2009 / Is routine dissection of level II-B and V-A necessary in patients with papillary thyroid cancer undergoing lateral neck dissection for FNA-confirmed metast

Fukui Y / 2001 / Sentinel lymph node biopsy in patients with papillary thyroid carcinoma / Cancer 92 : 2868 ~ 2874