Incidence of Metastatic Well-Differentiated Thyroid Cancer in Cervical Lymph Nodes

Abstract

An aggressive approach to detecting and treating occult lateral cervical nodes by techniques such as jugular node sampling, sentinel node biopsy, or image-guided needle biopsy is not necessary in most patients. Attempts to detect and remove occult lateral cervical lymph node metastases might be considered in older patients with large primary tumors.

Dissection of Right Upper Paraesophageal Lymph Node for Management of Recurrent Nodal Lesion in Papillary Thyroid Cancer (PTC)

“…In one study, a meta-analysis of six papers reported that the metastatic rate of RUPELN in PTC patients ranged from 5.8% to 26.7%. 22) These results are comparable with the metastatic rate (14.3%) of prophylactic CCND at repeat surgery. However, when therapeutic CCND at reoperation was conducted, the metastatic rate of RUPELN (30.6%) was much higher than prophylactic CCND performed at reoperation and initial surgery.…”

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

“…Remove the primary tumor, disease that has extended beyond the thyroid capsule, and clinically significant lymph node metastases. Completeness of surgical resection is an important determinant of outcome, while residual metastatic lymph nodes represent the most common site of disease persistence/recurrence (270 –272).…”

Use of preoperative ultrasonography as guidance for neck dissection in patients with papillary thyroid carcinoma

“…For example, when patients with differentiated thyroid carcinomas underwent neck dissection only in the presence of palpable nodes, the rate of recurrence in the lateral neck was 3%, suggesting that US evaluation of the neck would have little additional benefit [21]. In that study, however, postoperative follow-up was limited to physical examination: therefore, many patients may have been diagnosed as having persistent or recurrent disease due to inadequate preoperative imaging or incomplete initial surgery [7].…”