Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus.
10.4174/astr.2018.94.5.229
- Author:
Young Woo CHANG
1
;
Hye Yoon LEE
;
Hwan Soo KIM
;
Hoon Yub KIM
;
Jae Bok LEE
;
Gil Soo SON
Author Information
1. Department of Surgery, Korea University College of Medicine, Seoul, Korea. gsson@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Papillary thyroid carcinoma;
Papillary thyroid microcarcinoma;
Lymph node excision
- MeSH:
Humans;
Incidence;
Lymph Node Excision*;
Lymph Nodes*;
Multivariate Analysis;
Neoplasm Metastasis;
Risk Factors;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy;
Trachea
- From:Annals of Surgical Treatment and Research
2018;94(5):229-234
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear. METHODS: This study enrolled 282 patients who underwent total thyroidectomy with bilateral central lymph node dissection. The patients were divided into 2 groups based on the location of the median line of the PTC. Group I included patients in whom the median line was located between the lateral margins of the trachea; group II included all others. We compared the 2 groups and conducted a multivariate analysis to assess risk factors for contralateral node metastasis from a PTC arising from the isthmus. RESULTS: Patients in group I had significantly higher frequencies of extrathyroidal extension and central lymph node metastasis. Group I also had a higher frequency of contralateral node metastasis, and a tumor size >1.0 cm was identified as an independent risk factor for contralateral node metastasis among patients in this group. CONCLUSION: Bilateral central lymph node dissection could be considered for patients with isthmic PTCs >1.0 cm in size who have clinically suspicious node metastasis.
