Dissection of Levels II Through V Is Required for Optimal Outcomes in Patients with Lateral Neck Lymph Node Metastasis from Papillary Thyroid Carcinoma

Javid, Mahsa; Graham, Emma; Malinowski, Jennifer; Gibson, Courtney; Carling, Tobias; Udelsman, Robert; Callender, Glenda G.

doi:10.1016/j.jamcollsurg.2016.02.006

Cited by 48 publications

(36 citation statements)

References 43 publications

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“…The rate of LRR after unilateral MRND in the present study was 7·9 per cent, which is lower than that in previous studies. This finding may be explained by a relatively short follow‐up duration (mean 56·3 months) and the exclusion of patients undergoing bilateral MRND.…”

Section: Discussioncontrasting

confidence: 87%

“…Factors predictive of multilevel metastasis were investigated to determine indications for extensive lateral neck dissection in N1b PTC. Guidelines and several recent articles have suggested that comprehensive MRND, including level II–V dissection, is necessary to optimize disease control in the lateral neck compartment. However, other studies have opposed MRND as it introduces potential morbidity, such as injury to the spinal accessory nerve.…”

Section: Discussionmentioning

confidence: 99%

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Patterns, predictive factors and prognostic impact of multilevel metastasis in N1b papillary thyroid carcinoma

Kim

Park

Hur

et al. 2017

British Journal of Surgery

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Section: Discussioncontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Patterns, predictive factors and prognostic impact of multilevel metastasis in N1b papillary thyroid carcinoma

Kim

Park

Hur

et al. 2017

British Journal of Surgery

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“…The incidence of thyroid cancer has tripled over the past three decades, and great improvements in related surgical techniques have occurred in the last 20 years . Therapeutic lateral neck dissection (LND) is indicated for patients with clinically evident lateral cervical lymph node involvement . However, the relatively extensive lateral cervical compartment dissection that is required has associated cosmetic concerns as well as a potentially high prevalence of complications .…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

et al. 2019

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Background: Endoscopic thyroidectomy is popular among patients with cosmetic requirements. However, when lateral neck dissection (LND) is required, endoscopic surgery may be challenging. Therefore, we introduced needle-assisted endoscopic technique to achieve endoscopic LND procedure and evaluated its safety and feasibility in the present study. Methods: Medical records of 37 patients who underwent needle-assisted endoscopic thyroidectomy with LND were retrospectively reviewed. Results: All of 37 patients had excellent cosmetic outcomes. The mean operative time was 338.2 ± 58.74 minutes. Mean number of lymph nodes retrieved in the lateral was 33.5 ± 11.69 and 15.9 ± 7.51 in the central neck. The rates of transient and permanent hypocalcemia were 32.4% and 2.7% and the rates of transient and permanent recurrent laryngeal nerve palsy were 8.1% and 0%, respectively. Conclusions: Needle-assisted endoscopic thyroidectomy with lateral neck dissection shows potential feasibility but further study is needed to better characterize its safety and applicability. K E Y W O R D Spapillary thyroid carcinoma, endoscopic thyroidectomy, lateral neck dissection, needle assisted, anterior chest approach

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“…al. who reported a series of 241 lateral neck dissections for PTC and found level V involvement in 16.9% of cases [9]. Their series had a recurrence rate of 10.9%, all in patients who had comprehensive dissection of levels II–V, with 3 cases of recurrence involving level V. Again, these authors argue that level V dissection is always necessary as there is disease involvement in about one-fifth of cases.…”

Section: Discussionmentioning

confidence: 99%

Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection

McMullen

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundPractice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection.MethodsWe performed a retrospective medical record review of PTC patients with lateral neck nodal metastases treated at University Health Network from 2000 to 2012. Predictive factors for regional neck recurrence, including extent of initial neck dissection, were analyzed using Cox regression.ResultsOut of 204 neck dissections in 178 patients, 110 (54%) underwent selective and 94 (46%) had comprehensive dissection including level Vb. Mean follow-up was 6.3 years (SD). Significant predictors of regional failure were the total number of suspicious nodes on preoperative imaging (p = 0.029), largest positive node on initial neck dissection (p < 0.01), and whether patients received adjuvant radiotherapy (p = 0.028). The 5-year ipsilateral regional recurrence rate was 8 and 9% with selective and comprehensive dissection, respectively (p = 0.89).ConclusionThe extent of neck dissection did not predict the probability of regional recurrence in PTC patients presenting with lateral neck metastases.

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Dissection of Levels II Through V Is Required for Optimal Outcomes in Patients with Lateral Neck Lymph Node Metastasis from Papillary Thyroid Carcinoma

Cited by 48 publications

References 43 publications

Patterns, predictive factors and prognostic impact of multilevel metastasis in N1b papillary thyroid carcinoma

Patterns, predictive factors and prognostic impact of multilevel metastasis in N1b papillary thyroid carcinoma

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection

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