Incidence and clinical characteristics of prelaryngeal lymph node metastasis in papillary thyroid cancer

Abstract

There is little data that determine the clinical characteristics of prelaryngeal lymph nodes (PLN) metastasis in patients with papillary thyroid cancer (PTC). The aims of this prospective study were to evaluate the incidence and the clinical characteristics of metastasis to the PLN for PTC patients who underwent total thyroidectomy and prophylactic central neck dissection. Sixty-seven patients who underwent total thyroidectomy and prophylactic bilateral central lymph node neck dissection for PTC were enrolled. Central neck compartment was further divided into prelaryngeal, ipsilateral/contralateral paratracheal, and pretracheal regions. Clinicopathologic factors including age, sex, tumor size and location, extrathyroidal extension, and central and lateral nodal metastasis were evaluated. Of the 67 patients who underwent PLN dissection, 13 (19.4 %) had evidence of PLN metastasis. Tumor size was significantly larger in patients with PLN involvement (2.28 versus 1.12 cm; p = 0.020). Additionally, primary tumors larger than 1 cm, extrathyroidal extension, and isthmus involvement were more prevalent in PLN-positive patients. Patients with positive PLNs were also more frequently found to have lateral lymph node metastasis (23.1 vs. 1.9 %; p = 0.021), pretracheal lymph node metastasis (76.9 vs. 27.8 %; p = 0.003), and bilateral central lymph node metastasis (38.5 vs. 11.1 %; p = 0.031) than PTC patients without PLN involvement. The incidence of PLN metastasis in PTC patients who underwent prophylactic central lymph node neck dissection was 19.4 %. PLN metastasis was associated with tumor size, extrathyroidal extension, isthmus involvement, and other compartment lymph node metastasis.

Lateral neck metastases in the ipsilateral and contralateral compartments of papillary thyroid carcinoma located in one lobe

“…Several reports have shown a significant association between Delphian lymph node metastasis and LNM. 22,23 When the Delphian lymph node is involved, the rate of LNM has been reported to range from 23.1% to 74%. 24,25 In our study, 18.1% of patients with ULNM and 36.2% of those with BLNM had Delphian lymph node metastasis.…”

Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

“…First, this is a cross-sectional study without followup, which makes it impossible to determine whether DLN is a direct prognostic factor for unilateral PTC patients. [17][18][19][20][21][22][23]. The rst published study evaluating the associations between DLN metastasis and prognosis of thyroid cancer found that DLN metastasis was signi cantly associated with larger tumor size and was highly predictive of metastasis in other lymph nodes [17].…”

“…The status of DLN metastasis has been shown to be important in deciding the extent of operation, estimating prognosis after the operation and planning radiotherapy [16]. However, there is no consensus on the value of DLN metastasis in the management of thyroid cancer and the number of studies evaluating the role of DLN metastasis in the prognosis of unilateral PTC is still very limited [17][18][19][20][21][22][23]. Therefore, the present study was designed to determine whether DLN metastasis is associated with any prognostic factors of unilateral PTC.…”

Thyroid cancer and Delphian node

“…The manuscript published in this volume of the European Archives of Otolaryngology discusses the incidence and impact of pre-laryngeal nodal metastasis in thyroid cancer [1]. The authors have used the title pre-laryngeal synonymous to Delphian nodes.…”