Salvage central neck dissection for papillary thyroid cancer
10.3760/cma.j.issn.1673-0860.2012.10.007
- VernacularTitle:补救性中央区淋巴清扫术在甲状腺乳头状癌中的应用
- Author:
Wen-Bin YU
1
;
Yun-Tao SONG
;
Nai-Song ZHANG
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所
- Keywords:
Thyroid neoplasms;
Carcinoma,papillary;
Radical neck dissection
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2012;47(10):823-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the salvage central neck dissection (CND) for papillary thyroid cancer in the patients with suspicious residual positive lymph nodes in the central compartment.Methods A total of 85 cases undergoing salvage CND between January 2006 to Janurary 2009 was reviewed.Results Fifty-nine (69.4％) of the 85 patients showed residual positive lymph nodes in the central compartments.The number of dissected lymph nodes for each dissection ranged 2 - 13 nodes,with an average of 5.7 nodes.A total of 159 positive lymph nodes were found in the 59 cases,with an average of 2.7 positive nodes in each case.Four of 6 patients who underwent initial CND in other hospitals were found with residual positive nodes in the central apartments.The incidence of postoperative complications for the salvage CND was 10.6％(9/85),of them 5 cases with hoarsness,2 cases with transient hypoparathyroidism, 1 case with postoperative bleeding,and 1 case with subplatysmal effusion. The median of follow-up after salvage CND was 44 months (3-5 years),showing contralateral central recurrence in 1 case,lateral neck recurrence in 4 cases,lung metastasis in 1 case,and no death case.Conclusions Salvage CND should be done for those patients without undergoing initial CND but with positive nodes found after thyroidectomy or the high risks ( T3,T4,extrathyroid extension,residual in primary site,and vascular or lymphatic vessel invasion) ; and also for those patients with initial CND but insufficient extent.
