scholarly journals Patterns of Cervical Lymph Node Metastases in Primary and Recurrent Papillary Thyroid Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Neda Ahmadi ◽  
Ameet Grewal ◽  
Bruce J. Davidson
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Recurrent Disease ◽  
The United States ◽  
Common Type ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Level Ii ◽  
Node Metastases ◽  
Level I

The incidence of thyroid cancer is rising in the United States with papillary thyroid cancer (PTC) being the most common type. We performed a retrospective study of 49 patients with PTC who underwent 57 lateral neck dissections (NDs). The extent of NDs varied, but 29 of 57 (51%) consisted of levels II–V. Twelve of 57 (21%) NDs consisted of levels I–V. Twelve of 57 (21%) NDs consisted of levels II–IV. One of 57 (1.8%) necks involved only levels I–IV. One of 57(1.8%) necks involved only levels I–V. One of 57(1.8%) necks involved only levels III–V. Two (3.5%) double-level (III–IV) neck surgeries were also performed. Metastatic PTC adenopathy was confirmed pathologically in 2%-level-I, 45%-level-II, 57%-level-III, 60%-level-IV, and 22%-level-V necks. Level-V was positive in 21% of primary and 24% of recurrent groups (). Comparing primary and recurrent disease, there was no difference in nodal distribution or frequency for levels I, II, III, and V. Level-IV was more common in the recurrent cases (). Based on the pathologic distribution of nodes, dissection should routinely include levels II–IV and extend to level-V in primary and recurrent cases. Our data does not suggest routine dissection of level-I.

scholarly journals Qin’s seven steps for endoscopic selective lateral neck dissection via the chest approach in patients with papillary thyroid cancer: experience of 35 cases

2021 ◽  
Author(s):  
Zhen-Xin Chen ◽  
Ya-Min Song ◽  
Jing-Bao Chen ◽  
Xiao-Bo Zhang ◽  
Zhan-Hong Lin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Neck Dissection ◽  
Nerve Injury ◽  
Papillary Thyroid Cancer ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Lateral Neck Dissection ◽  
Level Ii ◽  
The Mean

Abstract Background Endoscopic thyroidectomy is widely performed as it does not result in neck scar. However, there is a paucity of reports pertaining to completely endoscopic lateral neck dissection (LND). In this study, we introduce our step-wise approach for performing endoscopic selective LND via the chest–breast approach. We refer to this approach as Qin’s seven steps. Methods The Qin’s seven steps are: (1) establishment of working space range; (2) dissection of lymph nodes between the SCM and the sternohyoid muscle (level IV) and exposure of omohyoid; (3) dissection of lymph nodes at level IV; (4) dissection of lymph nodes at level III; (5) dissection of lymph nodes at carotid triangle (level III); (6) exposure of accessory nerve and dissection of lymph nodes at level II a; (7) dissection of lymph nodes at level II b. We reviewed the clinical data of 35 patients with papillary thyroid cancer (PTC) who were operated using the Qin’s seven steps. Results All 35 patients successfully underwent LND; bilateral LND was performed in 5 patients. The mean tumor size was 1.8 ± 1.0 cm; seven patients had multiple lesions. The mean number of retrieved lymph nodes in level II, III and IV were 8.8 ± 5.6, 6.1 ± 4.0 and 9.3 ± 5.1, respectively. As for complications, there were 3 cases of accessory nerve injury and 1 case of hypoglossal nerve injury. Internal jugular vein injury, cervical plexus injury and lymphatic leakage occurred in 2, 7, and 1 patients, respectively. Conclusion The Qin’s seven steps for performing endoscopic selective LND could be safely used in PTC patients with lateral lymph node metastasis. Satisfactory results were achieved in the short-term follow-up period. We recommend the use of Qin’s seven steps for PTC patients who are not desirous of neck scar.

scholarly journals The Value of Intraoperative Ultrasound in Selective Lateral Cervical Neck Lymphadenectomy for Papillary Thyroid Cancer: A Prospective Pilot Study

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2737
Author(s):  
Giovanna Di Meo ◽  
Francesco Paolo Prete ◽  
Giuseppe Massimiliano De Luca ◽  
Alessandro Pasculli ◽  
Lucia Ilaria Sgaramella ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Intraoperative Ultrasound ◽  
Selective Neck Dissection ◽  
Diagnostic Study ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Nodal Involvement ◽  
Node Metastases

(1) Background: Lymph node metastases from papillary thyroid cancer (PTC) are frequent. Selective neck dissection (SND) is indicated in PTC with clinical or imaging evidence of lateral neck nodal disease. Both preoperative ultrasound (PreUS) and intraoperative palpation or visualization may underestimate actual lateral neck nodal involvement, particularly for lymph-nodes located behind the sternocleidomastoid muscle, where dissection may also potentially increase the risk of postoperative complications. The significance of diagnostic IOUS in metastatic PTC is under-investigated. (2) Methods: We designed a prospective diagnostic study to assess the diagnostic accuracy of IOUS compared to PreUS in detecting metastatic lateral neck lymph nodes from PTC during SND. (3) Results: There were 33 patients with preoperative evidence of lateral neck nodal involvement from PTC based on PreUS and fine-needle cytology. In these patients, IOUS guided the excision of additional nodal compartments that were not predicted by PreUS in nine (27.2%) cases, of which eight (24.2%) proved to harbor positive nodes at pathology. The detection of levels IIb and V increased, respectively, from 9% (PreUS) to 21% (IOUS) (p < 0.0001) and from 15% to 24% (p = 0.006). (4) Conclusions: In the context of this study, IOUS showed higher sensitivity and specificity than PreUS scans in detecting metastatic lateral cervical nodes. This study showed that IOUS may enable precise SND to achieve oncological radicality, limiting postoperative morbidity.

scholarly journals The Most Commonly Occurring Papillary Thyroid Cancer in the United States Is Now a Microcarcinoma in a Patient Older than 45 Years

Thyroid ◽  
2011 ◽  
Vol 21 (3) ◽  
pp. 231-236 ◽  
Author(s):  
David T. Hughes ◽  
Megan R. Haymart ◽  
Barbra S. Miller ◽  
Paul G. Gauger ◽  
Gerard M. Doherty
Keyword(s):  
United States ◽  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
The United States ◽  
Papillary Thyroid

Utilization of total thyroidectomy for papillary thyroid cancer in the United States

Surgery ◽  
2007 ◽  
Vol 142 (6) ◽  
pp. 906-913.e2 ◽  
Author(s):  
Karl Y. Bilimoria ◽  
David J. Bentrem ◽  
John G. Linn ◽  
Andrew Freel ◽  
Jen Jen Yeh ◽  
...  
Keyword(s):  
United States ◽  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Cancer ◽  
The United States ◽  
Papillary Thyroid

Surgical drains can be safely avoided in lateral neck dissections for papillary thyroid cancer

2010 ◽  
Vol 199 (4) ◽  
pp. 485-490 ◽  
Author(s):  
Michal Mekel ◽  
Antonia E. Stephen ◽  
Randall D. Gaz ◽  
Gregory W. Randolph ◽  
Sara Richer ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Lateral Neck ◽  
Papillary Thyroid
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