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

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 consist...

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Autores principales: Zhang, Xiao-Jun, Liu, Dan, Xu, De-Bin, Mu, Ya-Qi, Chen, Wen-Kuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4222844/
https://www.ncbi.nlm.nih.gov/pubmed/24274694
http://dx.doi.org/10.1186/1477-7819-11-304
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author Zhang, Xiao-Jun
Liu, Dan
Xu, De-Bin
Mu, Ya-Qi
Chen, Wen-Kuan
author_facet Zhang, Xiao-Jun
Liu, Dan
Xu, De-Bin
Mu, Ya-Qi
Chen, Wen-Kuan
author_sort Zhang, Xiao-Jun
collection PubMed
description 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.
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spelling pubmed-42228442014-11-07 Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma? Zhang, Xiao-Jun Liu, Dan Xu, De-Bin Mu, Ya-Qi Chen, Wen-Kuan World J Surg Oncol Research 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. BioMed Central 2013-11-25 /pmc/articles/PMC4222844/ /pubmed/24274694 http://dx.doi.org/10.1186/1477-7819-11-304 Text en Copyright © 2013 Zhang et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Zhang, Xiao-Jun
Liu, Dan
Xu, De-Bin
Mu, Ya-Qi
Chen, Wen-Kuan
Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?
title Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?
title_full Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?
title_fullStr Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?
title_full_unstemmed Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?
title_short Should level V be included in lateral neck dissection in treating papillary thyroid carcinoma?
title_sort should level v be included in lateral neck dissection in treating papillary thyroid carcinoma?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4222844/
https://www.ncbi.nlm.nih.gov/pubmed/24274694
http://dx.doi.org/10.1186/1477-7819-11-304
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