Level I lymph node involvement in patients with N1b papillary thyroid carcinoma: a prospective study
| Autor: | Mohamed R Khalil, Tarek Koraitim, Yasser Hamza, Ahmad Eweida, Mahmoud Sakr, Basma Elsabaa, Aman S Nabawi, Essam Gabr, Hatem F Al-Wagih, Waleed Abo-Elwafa, Ahmed A Diab, Tarek Ezzat Abdel-Aziz |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030209 endocrinology & metabolism Gastroenterology Metastasis Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Neoplasm Invasiveness Prospective Studies Thyroid Neoplasms Thyroid Nodule Stage (cooking) Prospective cohort study Internal jugular vein Lymph node Neoplasm Staging business.industry Incidence Thyroid Carcinoma Neck dissection General Medicine Middle Aged medicine.disease Prognosis Carcinoma Papillary Surgery medicine.anatomical_structure Otorhinolaryngology Thyroid Cancer Papillary 030220 oncology & carcinogenesis Lymphatic Metastasis Thyroidectomy Neck Dissection Egypt Female Lymph Nodes business |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 274(4) |
| ISSN: | 1434-4726 |
| Popis: | Most of the studies on the incidence, pattern, and predictive factors of lymph node (LN) metastasis with papillary thyroid carcinoma (PTC) have been performed retrospectively and no common consensus has been reached regarding the predictors for the involvement of level I LNs. This study was conducted prospectively to determine the incidence and the possible predictors of level I involvement in N1b PTC patients. The study included 30 consecutive patients with N1b stage of PTC. All the patients underwent neck dissection (ND) including level I. The relation between involvement of level I LNs and various clinicopathological variables was studied. Unilateral neck dissection was performed in 24 patients and bilateral neck dissection in six patients leading to 36 NDs. Level I was excised in all patients, with five specimens (14%) positive for metastasis. Levels II, III, IV, V, VI, and VII were positive in 52.8, 58.3, 58.3, 33.3, 63, and 22.2%, respectively. Level I involvement was significantly related to the number of lymph node levels affected (p = 0.003) and macroscopic extranodal invasion (p = 0.04). It was not related to the involvement of other individual levels, gender, age, size of the largest thyroid nodule, size of the largest LN involved, or histo-pathological variant of the tumor. This study suggests that including level I in therapeutic neck dissection for N1b PTC patients might be recommended in selected cases of multiple level involvement and macroscopic extranodal invasion requiring sacrifice of internal jugular vein, spinal accessory nerve, or sternomastoid muscle. |
| Databáze: | OpenAIRE |
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