갑상선 유두암의 우측 식도곁림프절(Right Paraesophageal Lymph Node) 전이 및 예방적 절제에 관한 후향적 연구
Right Paraesophageal Lymph Node Metastasis in Papillary Thyroid Cancer and Prophylactic Dissection: A Retrospective Study
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Purpose: The purpose of this study is to determine the status of nodal disease, including the right paraesophageal node, in papillary thyroid carcinoma (PTC). Methods: A total of 116 patients with PTC underwent total thyroidectomy and prophylactic central node dissection, including right paraesophageal lymph nodes (RPE LNs). Metastases to RPELNs were analyzed by site and clinicopathologic variables. Recurrence rate and post-operative complications were also evaluated by comparing the right paraesophageal lymph node dissection (RPE LND) with the non-RPE LND group. Results: Central node metastases were detected in 57 (49.1%) patients; paratracheal and pre-tracheal lymph node metastases, total RPE LN metastases, and metastases only in RPE LN occurred in 50 (43.1%), 18 (15.5%), and 5 (4.3%) patients, respectively. Age, tumor size, tumor longitudinal location, extrathyroidal extension, and multicentricity were insignificant in RPE LN metastasis (P＞.05). Although there was no significant statistical difference, tumors with lymphatic invasion and larger tumors (＞1 cm) had more frequent RPE LN metastases. RPE LN metastases were frequent in deeply located tumors instead of superficially located tumors (P=0.015). Compared with the non-RPE LND group, the incidence of post-operative complications (transient hypocalcemia and vocal cord palsy) was not significantly different and there was no recurrence in both groups during the follow up period. Conclusion: The metastatic rate of the right paraesophageal lymph nodes was 15.5%; 83.3% of these were macrometastatic. Prophylactic RPE dissection compared with the non-RPE LND group, however, did not show a survival difference for 5 years.
Abstract
Purpose: The purpose of this study is to determine the status of nodal disease, including the right paraesophageal node, in papillary thyroid carcinoma (PTC). Methods: A total of 116 patients with PTC underwent total thyroidectomy and prophylactic central node dissection, including right paraesophageal lymph nodes (RPE LNs). Metastases to RPELNs were analyzed by site and clinicopathologic variables. Recurrence rate and post-operative complications were also evaluated by comparing the right paraesophageal lymph node dissection (RPE LND) with the non-RPE LND group. Results: Central node metastases were detected in 57 (49.1%) patients; paratracheal and pre-tracheal lymph node metastases, total RPE LN metastases, and metastases only in RPE LN occurred in 50 (43.1%), 18 (15.5%), and 5 (4.3%) patients, respectively. Age, tumor size, tumor longitudinal location, extrathyroidal extension, and multicentricity were insignificant in RPE LN metastasis (P＞.05). Although there was no significant statistical difference, tumors with lymphatic invasion and larger tumors (＞1 cm) had more frequent RPE LN metastases. RPE LN metastases were frequent in deeply located tumors instead of superficially located tumors (P=0.015). Compared with the non-RPE LND group, the incidence of post-operative complications (transient hypocalcemia and vocal cord palsy) was not significantly different and there was no recurrence in both groups during the follow up period. Conclusion: The metastatic rate of the right paraesophageal lymph nodes was 15.5%; 83.3% of these were macrometastatic. Prophylactic RPE dissection compared with the non-RPE LND group, however, did not show a survival difference for 5 years.
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