Is the Internal Jugular Node Dissection without Level V Sufficient in Patients with Papillary Thyroid Carcinoma with Lateral Neck Node Metastasis?
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, and completeness of surgical resection is an important determinant of outcomes. The appropriate extent of therapeutic lateral neck dissection remains controversial. This study aims to access the impact of lateral neck node dissection of levels II to V in a large patient series. Methods: A retrospective review of the clinical charts and hospital records of 778 consecutive patients who had metastatic PTC and who underwent unilateral cervical lymph node dissection at a single institution between 1999 January and 2009 December. Results: A total of 489 modified radical neck dissection (MRND) (levels II–V) and 289 internal jugular node dissection (IJND) (levels II–IV) were performed in 778 patients. There were no differences in clinicopathological findings except for the retrieved and metastatic lateral lymph nodes (LLNs). The multiple-level lymph node (LN) metastasis was more prevalent in the MRND group, and the distribution of metastasis lymph node levels was significantly different in both group. The recurrence rate and disease-free survival were similar in the 2 groups. In multivariate analysis, female sex, tumor size, and multi-level LLN metastasis were independent predictors recurrence. Postoperative complications were similar in MRND and IJND group. Conclusion: IJND achieves favorable postoperative results in PTC with lateral neck node metastasis patients, and level V metastasis/recurrence incidence is low. Therefore, the extent of lateral neck node dissection, whether IJND or MRND, can be considered for patients according to the simultaneous metastasis level and the tumor size.
Abstract
Purpose: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, and completeness of surgical resection is an important determinant of outcomes. The appropriate extent of therapeutic lateral neck dissection remains controversial. This study aims to access the impact of lateral neck node dissection of levels II to V in a large patient series. Methods: A retrospective review of the clinical charts and hospital records of 778 consecutive patients who had metastatic PTC and who underwent unilateral cervical lymph node dissection at a single institution between 1999 January and 2009 December. Results: A total of 489 modified radical neck dissection (MRND) (levels II–V) and 289 internal jugular node dissection (IJND) (levels II–IV) were performed in 778 patients. There were no differences in clinicopathological findings except for the retrieved and metastatic lateral lymph nodes (LLNs). The multiple-level lymph node (LN) metastasis was more prevalent in the MRND group, and the distribution of metastasis lymph node levels was significantly different in both group. The recurrence rate and disease-free survival were similar in the 2 groups. In multivariate analysis, female sex, tumor size, and multi-level LLN metastasis were independent predictors recurrence. Postoperative complications were similar in MRND and IJND group. Conclusion: IJND achieves favorable postoperative results in PTC with lateral neck node metastasis patients, and level V metastasis/recurrence incidence is low. Therefore, the extent of lateral neck node dissection, whether IJND or MRND, can be considered for patients according to the simultaneous metastasis level and the tumor size.
참고문헌 (37)
- 홍세리, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017", Cancer Research and Treatment, 52(2), pp.335~350 (2020), 대한암학회
- Kim E, "Preoperative diagnosis of cervical metastatic lymph nodes in papillary thyroid carcinoma : comparison of ultrasound, computed tomography, and combined ultrasound with computed tomography", Thyroid, 18, pp.411~418 (2008)
- Mazzaferri EL, "Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer", Am J Med, 97, pp.418~428 (1994)
- Mirallié E, "Predictive factors for node involvement in papillary thyroid carcinoma. Univariate and multivariate analyses", Eur J Cancer, 35, pp.420~423 (1999)
- Moley JF, "Compartment-mediated dissection for papillary thyroid cancer", Langenbecks Arch Surg, 384, pp.9~15 (1999)
- Caron NR, "Papillary thyroid cancer : surgical management of lymph node metastases", Curr Treat Options Oncol, 6, pp.311~322 (2005)
- Crile G, "Landmark article Dec 1, 1906: excision of cancer of the head and neck. With special reference to the plan of dissection based on one hundred and thirty-two operations. By George Crile", JAMA, 258, pp.3286~3293 (1987)
- Haugen BR, "2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer", Thyroid, 26, pp.1~133 (2016)
- Stack BC Jr, "American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer", Thyroid, 22, pp.501~508 (2012)
- Kupferman ME, "Safety of modified radical neck dissection for differentiated thyroid carcinoma", Laryngoscope, 114, pp.403~406 (2004)
- Kupferman ME, "Predictors of level V metastasis in well-differentiated thyroid cancer", Head Neck, 30, pp.1469~1474 (2008)
- Turanli S, "Is the type of dissection in lateral neck metastasis for differentiated thyroid carcinoma important", Otolaryngol Head Neck Surg, 136, pp.957~960 (2007)
- Caron NR, "Selective modified radical neck dissection for papillary thyroid cancer-is level I, II and V dissection always necessary", World J Surg, 30, pp.833~840 (2006)
- 이초록, "분화 갑상선암에서 측경부 림프절 절제술의 범위", Journal of Endocrine Surgery, 14(1), pp.1~6 (2014), 대한내분비외과학회
- Battoo AJ, "Level V clearance in neck dissection for papillary thyroid carcinoma : a need for homogeneous studies", Int Arch Otorhinolaryngol, 22, pp.449~454 (2018)
- Kim SK, "Should level V be routinely dissected in N1b papillary thyroid carcinoma", Thyroid, 27, pp.253~260 (2017)
- Javid M, "Dissection of levels II through V is required for optimal outcomes in patients with lateral neck lymph node metastasis from papillary thyroid carcinoma", J Am Coll Surg, 222, pp.1066~1073 (2016)
- Park JS, "Performance of preoperative sonographic staging of papillary thyroid carcinoma based on the sixth edition of the AJCC", UICC TNM classification system, 2009, pp.192, 66~72
- Uruno T, "Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer", World J Surg, 29, pp.483~485 (2005)
- Patel KN, "Neck dissection : past, present, future", Surg Oncol Clin N Am, 14, pp.461~477 (2005)
- Morris LF, "Thyroid stunning", Thyroid, 13, pp.333~340 (2003)
- McConahey WM, "Papillary thyroid cancer treated at the Mayo Clinic, 1946 through 1970 : initial manifestations, pathologic findings, therapy, and outcome", Mayo Clin Proc, 61, pp.978~996 (1986)
- Mazzaferri EL, "Papillary thyroid carcinoma : factors influencing prognosis and current therapy", Semin Oncol, 14, pp.315~332 (1987)
- Akslen LA, "Prognostic importance of histologic grading in papillary thyroid carcinoma", Cancer, 72, pp.2680~2685 (1993)
- Patten C, "The 11th nerve syndrome. Accessory nerve palsy or adhesive capsulitis", Arch Otolaryngol Head Neck Surg, 119, pp.215~220 (1993)
- Inoue H, "Quality of life after neck dissection", Arch Otolaryngol Head Neck Surg, 132, pp.662~666 (2006)
- Sivanandan R, "Pattern of cervical lymph node metastases from papillary carcinoma of the thyroid", Br J Surg, 88, pp.1241~1244 (2001)
- Lee J, "Is level IIb lymph node dissection always necessary in N1b papillary thyroid carcinoma patients", World J Surg, 32, pp.716~721 (2008)
- Cooper DS, "Management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 16, pp.109~142 (2006)
- Cooper DS, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19, pp.1167~1214 (2009)
- Kandil E, "Impact of extensive neck dissection on survival from papillary thyroid cancer", ORL J Otorhinolaryngol Relat Spec, 73, pp.330~335 (2011)
- Noguchi M, "Impact of neck dissection on survival in well-differentiated thyroid cancer : a multivariate analysis of 218 cases", Int Surg, 75, pp.220~224 (1990)
- Roh JL, "Lateral cervical lymph node metastases from papillary thyroid carcinoma : pattern of nodal metastases and optimal strategy for neck dissection", Ann Surg Oncol, 15, pp.1177~1182 (2008)
- Lim YC, "Occult lymph node metastases in neck level V in papillary thyroid carcinoma", Surgery, 147, pp.241~245 (2010)
- Shim MJ, "Preoperative detection and predictors of level V lymph node metastasis in patients with papillary thyroid carcinoma", Br J Surg, 100, pp.497~503 (2013)
- Ito Y, "Risk factors contributing to a poor prognosis of papillary thyroid carcinoma : validity of UICC", AJCC TNM classification and stage grouping, 2007, pp.31, 838~848
- Noguchi S, "The value of lymph-node dissection in patients with differentiated thyroid cancer", Surg Clin North Am, 67, pp.251~261 (1987)