Occult lymph node metastases in neck level V in papillary thyroid carcinoma

Lim, Young Chang; Choi, Eun Chang; Yoon, Yeo-Hoon; Koo, Bon Seok

doi:10.1016/j.surg.2009.09.002

Cited by 38 publications

(52 citation statements)

References 17 publications

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“…30. In addition, most patients (137/220, 62.3%) in this study had multiple‐level metastases, which is consistent with the values reported in previous studies 16, 22. On the basis of the above reasons and the prognostic significance, it is universally agreed that therapeutic LND should include at least a comprehensive but selective LND of levels II–IV.…”

Section: Discussionsupporting

confidence: 91%

“…Secondly, the mean number of excised and metastatic lymph nodes and the median metastatic lymph node ratio were also lower in level V than that in other levels in the lateral compartment, which was consistent with the reported result by Lim et al. 16. Of course, those results might have been affected by the lower sampling lymph nodes on those areas.…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, determining a rational extent of therapeutic LND is vital. Whether level V should be included in therapeutic LND continues to be debated 16, 17, 18, 19, 20, 21, 22. A majority of previous studies had explored some predictors for level V LNM in PTC patients with clinically LLNM, but only a few studies have explored the risk factors for level V LNM in solitary PTC with clinically LLNM.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the above reasons and the prognostic significance, it is universally agreed that therapeutic LND should include at least a comprehensive but selective LND of levels II–IV. However, whether therapeutic LND should routinely include level V lymphadenectomy remains controversial 13, 14, 15, 16, 17, 18, 19, 20, 21, 22.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is debatable whether routine level V lymphadenectomy is necessary in patients with PTC with clinically LLNM 16, 17, 18, 19, 20, 21, 22. In addition, there have been few studies to explore the risk factors for level V LNM in solitary PTC with clinically LLNM.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

et al. 2016

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The extent of lateral neck dissection (LND) in surgical resection of papillary thyroid carcinoma (PTC) with clinically lateral LNM (LLNM) remains controversial. We aimed to explore the frequency of and risk factors for level V LNM in patients with solitary PTC and clinically LLNM. To analyze the frequency and risk factors for level V LNM, we retrospectively reviewed 220 solitary PTC patients who underwent total thyroidectomy, bilateral central neck dissection, and therapeutic LND. LLNM were present in 82.3% patients, and levels II–V LNM were present in 45.9%, 62.7%, 55.5%, and 12.3% patients, respectively. Ipsilateral level V LNM was significantly associated with tumor size >10 mm, extrathyroidal extension, ipsilateral central LNM ratio ≥50%, and contralateral central LNM (CLNM), bilateral CLNM, and simultaneous levels II–IV LNM. Contralateral CLNM was an independent risk factor for level V LNM. In patients with solitary PTC and clinically LLNM, level V LNM was relatively uncommon. Therefore, routine level V lymphadenectomy may be unnecessary in these patients unless level V LNM is suspected on preoperative examination or associated risk factors, especially contralateral CLNM, are present.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%