Regional Lymph Node Metastasis in Papillary Thyroid Cancer.
10.11106/cet.2014.7.2.129
- Author:
Jae Hyun PARK
1
;
Kang San LEE
;
Keum Seok BAE
;
Seong Joon KANG
Author Information
1. Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea. mdkang@yonsei.ac.kr
- Publication Type:Review
- Keywords:
Papillary thyroid cancer;
Lymph node;
Metastasis;
Central compartment;
Lateral neck
- MeSH:
Drainage;
Endocrine Gland Neoplasms;
Humans;
Lymph Node Excision;
Lymph Nodes*;
Neck Dissection;
Neoplasm Metastasis*;
Prognosis;
Recurrence;
Thyroglobulin;
Thyroid Gland;
Thyroid Neoplasms*
- From:Journal of Korean Thyroid Association
2014;7(2):129-135
- CountryRepublic of Korea
- Language:English
-
Abstract:
Papillary thyroid cancer is a common endocrine cancer and commonly presents with lymph node metastases. It has been generally accepted that lymphatic drainage occurs from the thyroid primarily to the central lymphatic compartment and secondarily to the lateral compartment nodes. Recently, improvements in the resolution of imaging studies and the availability of highly sensitive thyroglobulin assays have highlighted the importance of identifying disease in the pre-operative assessment and dealing effectively with metastatic regional disease in order to prevent recurrence. However, there are limitations to diagnosing central lymph node metastases. With unreliable imaging modalities, prophylactic central lymph node dissection should be performed on all patients with papillary thyroid cancer. In comparison with the central compartment, prophylactic lateral node dissection has little or no effect on improving the prognosis of patients with papillary thyroid cancer. Therefore, lateral node dissection is recommended only as a part of the therapeutic procedure. The extension of lateral neck dissection is recommended a comprehensive selective neck dissection of levels IIa, III, IV, and Vb. The rich lymphatic supply of the thyroid gland coupled with the propensity for nodal metastases in papillary thyroid cancer require the modern thyroid surgeon to be familiar with the indications for and techniques of regional lymph node dissection.
