Management of Regional Metastases in Well-Differentiated Thyroid Cancer

Ort, Stuart A.; Goldenberg, David

doi:10.1016/j.otc.2008.06.002

Cited by 7 publications

(7 citation statements)

References 56 publications

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“…It is associated with a very high rate of cervical lymph node metastasis (LNM). The incidence rate of regional neck disease is between 30% and 80% 2,3 . LNM is a risk factor for locoregional recurrence and has an impact on overall survival in older patients.…”

Section: Introductionmentioning

confidence: 99%

Lateral neck multilevel fine‐needle aspiration cytology and thyroglobulin estimation in papillary thyroid carcinoma

Song

Wang

et al. 2021

Laryngoscope Investig Oto

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Objective To assess the accuracy of preoperative ultrasound‐guided multilevel fine‐needle aspiration (FNA) cytology and thyroglobulin (Tg) estimation in mapping metastatic levels in the lateral neck, in patients with papillary thyroid carcinoma (PTC). Methods Patients with PTC clinically metastasizing to the lateral neck who were initially treated at the Peking University Cancer Hospital from June 2018 to September 2020 were included. FNA was performed preoperatively in each suspicious neck level; cytological examination (FNA‐C) and Tg measurement of the needle‐washout fluid (FNA‐Tg) were combined to determine metastasis. FNA‐Tg cutoff value was calculated, and the accuracy of FNA at different levels were evaluated. Results In total, 111 patients underwent 124 lymph node dissections. The best cutoff value of FNA‐Tg for the diagnosis of metastatic level was 1.0 ng/mL. Multilevel FNA showed sensitivity, specificity, positive predictive value, and negative predictive value in predicting single‐level metastasis of 100%, 61.0%, 43.9%, and 100%, respectively. In 64 (51.6%) cases, the involved levels diagnosed by FNA were consistent with that diagnosed by postoperative pathology. Conclusion FNA‐Tg improves the diagnostic performance of FNA‐C in lateral neck lymph node metastases. However, limited accuracy was obtained for preoperative multilevel FNA in predicting the extent of metastasis in the lateral compartment.

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Section: Introductionmentioning

confidence: 99%

Lateral neck multilevel fine‐needle aspiration cytology and thyroglobulin estimation in papillary thyroid carcinoma

Song

Wang

et al. 2021

Laryngoscope Investig Oto

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“…Gender was not determined to be a significant factor for recurrence in this study [12]. While there is no definitive answer on the effect of nodal metastasis on survival, it is generally agreed that nodal involvement increases rates of recurrent disease [13]. Locoregional recurrence in papillary thyroid cancer more often occurs in the lateral neck compartment (8.2%, N = 342) [10].…”

Section: Epidemiologymentioning

confidence: 68%

“…Central compartment dissection for recurrent PTC, while carrying an increased risk for hypoparathyroidism and recurrent laryngeal nerve injury, remains the treatment modality of choice for regional recurrent or metastatic disease [13,49]. Central neck dissection entails removal of all soft tissues in level VI and VII neck compartments in a patient who previously underwent thyroidectomy or central lymph node dissection.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Recurrent disease most often occurs in levels II-V involving the transverse cervical and spinal accessory lymph nodes [58]. Lateral compartment dissection carries its own set of complications, which include thoracic duct injury, internal jugular vein injury, carotid artery damage, spinal accessory nerve damage and brachial plexus injury, among others [13,59]. Nononcologic structures such as the jugular vein, spinal accessory nerve, and sternocleidomastoid should be retained unless directly invaded by tumor recurrence.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

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Recurrent Differentiated Thyroid Cancer

Tannouri

2012

J Curr Surg

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Despite high prevalence of malignancy of the thyroid, recurrent thyroid cancer remains a poorly understood entity. This paper aims to consolidate research and literature specifically on recurrent disease by discussing its epidemiology, genetics, surveillance, treatment and outcomes. Mutations in the BRAF and RET genes predispose to recurrent disease. Currently utilized surveillance methods include thyroglobulin monitoring, radioiodine body scanning, PET/ CT, and neck ultrasound. Surgical reoperation is optimal treatment of choice. Long term outcomes still remain poorly described.

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“…The incidence rate of regional neck disease is between 30% and 80%. 2,3 The current guidelines of the American Thyroid Association recommend "therapeutic lateral neck compartmental LN dissection for patients with biopsy-proven metastatic lateral cervical lymphadenopathy." 4 However, there are two major issues that remain unresolved: (1) whether ultrasound (US)-guided biopsy can re ect the real distribution of involved LNs at different levels and (2) the de nition of the exact extent of lateral neck dissection (LND).…”

Section: Introductionmentioning

confidence: 99%

The role of lateral neck multi-level fine-needle aspiration in predicting lymph node metastasis in patients with cN1b papillary thyroid carcinoma

Song

Wang

et al. 2020

Preprint

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Objective:To assess the accuracy of preoperative ultrasound (US)-guided multilevel fine-needle aspiration (FNA) in mapping metastatic levels in the lateral neck, and its potentiality as a predictor of superselective neck dissection.Methods: Patients with PTC metastasizing to the lateral neck who were initially treated at Peking University Cancer Hospital from June 2018 to January 2020 were included. FNA was performed preoperatively; cytological examination (FNA-C) and thyroglobulin measurement of the needle washout fluid (FNA-Tg) were combined to determine metastatic neck levels.Results: In total, 91 patients underwent 103 LNDs. The best cutoff value of FNA-Tg for the diagnosis of metastatic level was 1.0 ng/ml. In 52/103 (50.5%) cases, the involved levels diagnosed by FNA were consistent with that diagnosed by postoperative pathology. By univariate analysis, in patients with three or more positive levels diagnosed by FNA, the rate of level ⅡB and VB metastasis was significantly higher (P<0.05).Conclusion: Multilevel FNA has limited accuracy in predicting the extent of metastasis in the lateral neck of PTC patients. However, if three or more levels are positive in the preoperative FNA-C or FNA-Tg, the LND should encompass levels ⅡB and ⅤB.

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Management of Regional Metastases in Well-Differentiated Thyroid Cancer

Cited by 7 publications

References 56 publications

Lateral neck multilevel fine‐needle aspiration cytology and thyroglobulin estimation in papillary thyroid carcinoma

Lateral neck multilevel fine‐needle aspiration cytology and thyroglobulin estimation in papillary thyroid carcinoma

Recurrent Differentiated Thyroid Cancer

The role of lateral neck multi-level fine-needle aspiration in predicting lymph node metastasis in patients with cN1b papillary thyroid carcinoma

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