High rate of IIA/IIB neck groups involvement supports complete lateral neck dissection in thyroid carcinoma

Chebib, Emilien; Eymerit, Caroline; Chabbert-Buffet, Nathalie; Angelard, B.; Guily, Jean Lacau St; Périé, Sophie

doi:10.21037/gs-20-443

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…In that situation, the accessory nerve is susceptible to strain and damage [ 7 ]. Moreover, a few studies have reported a low rate of lymphatic metastasis in level IIB, and the controversial point of the extent of neck dissection is whether lymph node dissection in level IIb is performed routinely [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Patterns of lymph node metastasis in level IIB and contralateral level VI for papillary thyroid carcinoma with pN1b and safety of low collar extended incision for neck dissection in level II

Ning,

Liu,

Zeng

et al. 2023

World J Surg Onc

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Objective To explore relevant clinical factors of level IIB and contralateral level VI lymph node metastasis and evaluate the safety of low-collar extended incision (LCEI) for lymph node dissection in level II for papillary thyroid carcinoma (PTC) with pN1b. Method A retrospective analysis was performed on 218 patients with PTC with pN1b who were treated surgically in the Head and Neck Surgery Center of Sichuan Cancer Hospital from September 2021 to May 2022. Data on age, sex, body mass index (BMI), tumor location, maximum tumor diameter, multifocality, Braf gene, T staging, surgical incision style, and lymph node metastasis in each cervical subregion were collected. The chi-square test was used for comparative analysis of relevant factors. All statistical analyses were completed by SPSS 24 software. Result Each subgroup on sex, age, BMI, multifocality, tumor location, extrathyroidal extension, Braf gene, and lymphatic metastasis in level III, level IV, and level V had no significant difference in the positive rate of lymph node metastasis in level IIB (P > 0.05). In contrast, patients with bilateral lateral cervical lymphatic metastasis were more likely to have level IIB lymphatic metastasis than those with unilateral lateral cervical lymphatic metastasis, with a statistically significant difference (P = 0.000). In addition, lymph node metastasis in level IIA was significantly associated with lymph node metastasis in level IIB (P = 0.001). After multivariate analysis, lymph node metastasis in level IIA was independently associated with lymph node metastasis in level IIB (P = 0.010). The LCEI group had a similar lymphatic metastasis number and lymphatic metastasis rate in both level IIA and level IIB as the L-shaped incision group (P > 0.05). There were 86 patients with ipsilateral central lymphatic metastasis (78.2%). Patients with contralateral central lymphatic metastasis accounted for 56.4%. The contralateral central lymphatic metastasis rate was not correlated with age, BMI, multifocality, tumor invasion, or ipsilateral central lymphatic metastasis, and there was no significant difference (P > 0.05). The contralateral central lymphatic metastasis in males was slightly higher than that in females, and the difference was statistically significant (68.2% vs. 48.5%, P = 0.041). Conclusion Lymphatic metastasis in level IIA was an independent predictor of lymphatic metastasis in level IIB. When bilateral lateral cervical lymphatic metastasis or lymph node metastasis of level IIA is found, lymph node dissection in level IIB is strongly recommended. When unilateral lateral cervical lymphatic metastasis and lymphatic metastasis in level IIA are negative, lymph node dissection in level IIB may be performed as appropriate on the premise of no damage to the accessory nerve. LCEI is safe and effective for lymph node dissection in level II. When the tumor is located in the unilateral lobe, attention should be given to contralateral central lymph node dissection because of the high lymphatic metastasis rate.

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Section: Introductionmentioning

confidence: 99%

Patterns of lymph node metastasis in level IIB and contralateral level VI for papillary thyroid carcinoma with pN1b and safety of low collar extended incision for neck dissection in level II

Ning,

Liu,

Zeng

et al. 2023

World J Surg Onc

View full text Add to dashboard Cite

show abstract

“…In that situation, the accessory nerve is susceptible to strain and damage [6]. What is more,a few studies have reported a low rate of lymphatic metastasis in level IIB, the controversial point of the extent of neck dissection is whether lymph node dissection in level IIb is performed routinely [7].…”

Section: Introductionmentioning

confidence: 99%

Patterns of lymph node metastasis in Level IIB and Contralateral Level VI for Papillary Thyroid Carcinoma with pN1b and Safety of low collar extended incision for neck dissection in Level II

Ning

Zeng

Zhou

et al. 2022

Preprint

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Objective To explore relevant clinical factors of Level IIB and contralateral Level VI lymph node metastasis and evaluate the safety of low -collar extended incision(LCEI) for lymph node dissection in level II for papillary thyroid carcinoma(PTC) with pN1b. Method A retrospective analysis was performed on 218 patients with PTC with pN1b who were treated by surgery in the Head and Neck Surgery Center of Sichuan Cancer Hospital from September 2021 to May 2022.The data on age, gender, body mass index(BMI), tumor location, maximum tumor diameter, multifocality, Braf gene, T staging, surgical incision style and lymph node metastasis in each cervical subregion were collected. The chi-square test were used for comparative analysis of relevant factors. All statistical analysis was completed by SPSS.24 software. Result Each subgroup on gender, age, BMI, multifocality ,tumor location, extrathyroidal extension, Braf gene, lymphatic metastasis in level III, level IV and level V had no statistical difference in the positive rate of lymph node metastasis in level IIB(P > 0.05).In contrast, patients with bilateral lateral cervical lymphatic metastasis were more likely to have lymphatic metastasis in level IIB than those with unilateral lateral cervical lymphatic metastasis, with a statistically significant difference (P = 0.000). Besides, lymph node metastasis in level IIA was significantly associated with lymph node metastasis in level IIB (P = 0.001). The LCEI group had the similar lymphatic metastasis number and lymphatic metastasis rate in both level IIA and level IIB with the L-shaped incision group(P > 0.05).Patients with ipsilateral central lymphatic metastasis had 86 cases(78.2%). While patients with contralateral central lymphatic metastasis accounted for 56.4%.The contralateral central lymphatic metastasis rate was not correlated with age, BMI, multifocality, tumor invasion and ipsilateral central lymphatic metastasis, and there was no statistical difference (P > 0.05). The contralateral central lymphatic metastasis in males was slightly higher than that in females, and the difference was statistically significant (68.2%vs48.5%, P = 0.041). Conclusion Lymphatic metastasis in Level IIA was an independent predictor of lymphatic metastasis in Level IIB. When bilateral lateral cervical lymphatic metastasis or lymph node metastasis of level IIA are found, lymph node dissection in level IIB is strongly recommended.When unilateral lateral cervical lymphatic metastasis and lymphatic metastasis in level IIA is negative, lymph node dissection in level IIB may be performed as appropriate on the premise of no damage to the accessory nerve.LCEI is safe and effective for lymph node dissection in Level II. When the tumor is located in unilateral lobe, attention should be paid to the contralateral central lymph node dissection because of the high lymphatic metastasis rate.

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“…Первинні пухлини, що розташовані у верхній третині частки щитоподібної залози, мають схильність до метастазування у бокові відділи шиї (рівень II, III, IV) [21]. Лімфатичні вузли, які знаходяться попереду або контактують з внутрішньою яремною веною (рівень IIa), є прогностичними факторами метастазування для тих, що локалізуються в надостномозковому заглибленні (рівень IIb) [22]. Надключичні вузли посідають третє місце за частотою ураження (10-52%).…”

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Bibliometric analysis of scientific literature on biopsy of sentinel lymph nodes in patients with thyroid gland cancer

Moskalenko¹,

Kurochkin²

2022

Buk. Med. Herald

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Biopsy of sentinel lymphatics has reliably entered the guidelines for diagnosing and treating many malignant neoplasms, but the situation in patients with thyroid cancer remains debatable.Objective. The purpose of the work is the search, bibliometric analysis, and generalization of scientific literature data to study the prognostic value and features of regional metastasis of highly differentiated forms of thyroid cancer, as well as the study of sentinel lymph node biopsy techniques.Materials and methods. Two hundred forty-two literature sources containing information on sentinel lymph node biopsy in patients with papillary and follicular thyroid cancer were examined. The data search was conducted in the electronic databases of PubMed, Scopus, Web of Science, and Google Scholar using the following key terms: "thyroid cancer," "sentinel lymph node biopsy," and "dyes." Using visualization tools and modern citation metrics SciVal (Scopus) with the application of an online platform for monitoring and analyzing international scientific research, it was possible to perform a bibliometric analysis. Bibliometric networks were constructed and visualized using VOSviewer.Results and conclusions. Regional metastasis can occur both in stages and with the omission of the predicted department. Lymph nodes of the ipsilateral central department occupy the first place in damage frequency.Regional metastasis is recognized as a negative prognostic factor for the development of locoregional recurrence of the disease. The mortality rate increases only in risk factors such as age <45 years, bulky thyroid tumor, and involvement of up to 6 metastatic lymph nodes. The main criterion for the effectiveness of the contrast during sentinel lymph node biopsy is the negative predictive value and the false negative rate. According to the bibliographic analysis, interest in sentinel lymph node biopsy in patients with thyroid cancer continues to grow from 1998 to the present. With the help of the VOSviewer bibliometric network visualization tool, it was possible to analyze 242 scientific articles.

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High rate of IIA/IIB neck groups involvement supports complete lateral neck dissection in thyroid carcinoma

Cited by 6 publications

References 28 publications

Patterns of lymph node metastasis in level IIB and contralateral level VI for papillary thyroid carcinoma with pN1b and safety of low collar extended incision for neck dissection in level II

Patterns of lymph node metastasis in level IIB and contralateral level VI for papillary thyroid carcinoma with pN1b and safety of low collar extended incision for neck dissection in level II

Patterns of lymph node metastasis in Level IIB and Contralateral Level VI for Papillary Thyroid Carcinoma with pN1b and Safety of low collar extended incision for neck dissection in Level II

Bibliometric analysis of scientific literature on biopsy of sentinel lymph nodes in patients with thyroid gland cancer

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