Is the Internal Jugular Node Dissection without Level V Sufficient in Patients with Papillary Thyroid Carcinoma with Lateral Neck Node Metastasis?

Lee Cho Rok; Kim Jin Kyong; Kang Sang-Wook; Lee Jandee; Jeong Jong Ju; Nam Kee-Hyun; Chung Woong Youn

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저자정보: Lee Cho Rok (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Kim Jin Kyong (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Kang Sang-Wook (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Lee Jandee (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Jeong Jong Ju (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Nam Kee-Hyun (Department of Surgery Yonsei University College of Medicine Seoul Korea.) Chung Woong Youn (Department of Surgery Yonsei University College of Medicine Seoul Korea.)

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제20권 제3호

발행연도: 2020.1

수록면: 31 - 40 (10page)

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Purpose: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, and completeness of surgical resection is an important determinant of outcomes. The appropriate extent of therapeutic lateral neck dissection remains controversial. This study aims to access the impact of lateral neck node dissection of levels II to V in a large patient series. Methods: A retrospective review of the clinical charts and hospital records of 778 consecutive patients who had metastatic PTC and who underwent unilateral cervical lymph node dissection at a single institution between 1999 January and 2009 December. Results: A total of 489 modified radical neck dissection (MRND) (levels II?V) and 289 internal jugular node dissection (IJND) (levels II?IV) were performed in 778 patients. There were no differences in clinicopathological findings except for the retrieved and metastatic lateral lymph nodes (LLNs). The multiple-level lymph node (LN) metastasis was more prevalent in the MRND group, and the distribution of metastasis lymph node levels was significantly different in both group. The recurrence rate and disease-free survival were similar in the 2 groups. In multivariate analysis, female sex, tumor size, and multi-level LLN metastasis were independent predictors recurrence. Postoperative complications were similar in MRND and IJND group. Conclusion: IJND achieves favorable postoperative results in PTC with lateral neck node metastasis patients, and level V metastasis/recurrence incidence is low. Therefore, the extent of lateral neck node dissection, whether IJND or MRND, can be considered for patients according to the simultaneous metastasis level and the tumor size.

#Thyroid carcinoma #Neck dissection #Recurrence

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