Preliminary study of superselective lymph node dissection in regional lateral cervical lymph node metastasis of papillary thyroid carcinoma
10.3760/cma.j.cn112152-20201015-00901
- VernacularTitle:超择区性淋巴结清扫在甲状腺乳头状癌区域性侧颈淋巴结转移中的初步研究
- Author:
Bohui ZHAO
1
;
Zehao HUANG
;
Yingcheng HUANG
;
Xiwei ZHANG
;
Changming AN
;
Lijuan NIU
;
Zhengjiang LI
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院头颈外科 100021
- Keywords:
Papillary thyroid neoplasms;
Lymph node metastasis;
Super-selective neck lymph node dissection
- From:
Chinese Journal of Oncology
2021;43(4):484-489
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the applied value of super-selective cervical lymph node dissection in papillary thyroid carcinoma (PTC) patients with clinically suspicious lateral lymph node metastasis (LNM).Methods:We retrospectively analyzed the clinical data of 232 cN1b PTC patients who underwent surgery from September 2013 to May 2018 in the Department of Head and Neck Surgical Oncology, National Cancer Center. Among them, 90 cases received super-selective neck dissection (level Ⅲ and IV) and 142 cases underwent selective neck dissection (level Ⅱ-Ⅳ). The LNM of two groups were analyzed.Results:Postoperative pathological results showed that 173 cases had LNM in the central compartment. The LNM cases of level Ⅱ-Ⅳ were 47, 147 and 130, respectively. Eight patients of super-selective neck dissection and 6 of selective neck dissection had postoperative lymphatic fistulas ( P=0.146). No patients in super-selective neck dissection group while 9 patients in the selective lymph node dissection group had postoperatively permanent impairment of shoulder mobility, the difference was statistically significant ( P=0.015). In the super-selective neck dissection group, 2 patients had long-term postoperative incision discomfort, and 5 cases had obvious cicatrix after surgery. In the patients with selective neck dissection, 27 cases experienced long-term incision discomfort after surgery, and 26 patients had apparent scar tissue, the differences were statistically significant ( P<0.005). There was no recurrence during the follow-up. Conclusions:Super-selective neck dissection is a feasible, safe and effective treatment for cN1b PTC patients. It can improve the quality of postoperative life and avoid the over treatment for patients.
