Lymph Node Dissection in Thyroid Cancer

Dralle, Henning; Machens, Andreas

doi:10.1007/978-1-84628-881-4_13

Cited by 5 publications

(6 citation statements)

References 165 publications

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“… 6 , 9 According to previous studies, a serum CEA level of ≥30 ng/mL is suggestive of lymph node metastases in the central and lateral neck compartments. 1 , 7 , 23 In the present study, we also found that higher stratified basal CEA serum levels reflected the presence of cervical lymph node metastases. Unfortunately, the calcitonin level was not recorded in our whole cohort; therefore, the doubling time of calcitonin, which is known to be a better predictor of cervical lymph node metastases, could not be calculated.…”

Section: Discussionsupporting

confidence: 80%

“… 1 It accounts for 5% to 10% of all thyroid cancers and may be classified as either hereditary MTC (25%) or sporadic MTC (SMTC) (75%). 1 – 4 Parafollicular C cells can produce calcitonin and carcinoembryonic antigen (CEA), which are relatively sensitive and specific markers for both the preoperative diagnosis and follow-up of MTC. 1 , 5 , 6 Due to the lack of treatment options other than surgery, the standard treatment for MTC is total thyroidectomy with prophylactic central lymph node dissection in clinically node-negative patients and therapeutic neck dissection in clinically suspicious lymph node-positive patients.…”

Section: Introductionmentioning

confidence: 99%

“… 1 – 4 Parafollicular C cells can produce calcitonin and carcinoembryonic antigen (CEA), which are relatively sensitive and specific markers for both the preoperative diagnosis and follow-up of MTC. 1 , 5 , 6 Due to the lack of treatment options other than surgery, the standard treatment for MTC is total thyroidectomy with prophylactic central lymph node dissection in clinically node-negative patients and therapeutic neck dissection in clinically suspicious lymph node-positive patients. 7 – 10 However, controversy remains surrounding the indication for prophylactic lateral lymph node dissection.…”

Section: Introductionmentioning

confidence: 99%

“…Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor of the thyroid gland that is derived from parafollicular C cells and was first described in 1959. 1 It accounts for 5% to 10% of all thyroid cancers and may be classified as either hereditary MTC (25%) or sporadic MTC (SMTC) (75%). [1][2][3][4] Parafollicular C cells can produce calcitonin and carcinoembryonic antigen (CEA), which are relatively sensitive and specific markers for both the preoperative diagnosis and follow-up of MTC.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of risk factors for cervical lymph node metastases in patients with sporadic medullary thyroid carcinoma

Fan

Cheng

2018

J Int Med Res

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ObjectiveMedullary thyroid carcinoma (MTC) is classified as either sporadic or inherited. This study was performed to analyze the risk factors for cervical lymph node metastases and predict the indication for prophylactic lateral neck dissection in patients with sporadic MTC.MethodsSixty-five patients with sporadic MTC were retrospectively reviewed. Univariate analysis with the chi-square test and multiple logistic regression analysis were applied to identify the clinicopathological features (sex, age, tumor size, number of tumor foci, capsule or vascular invasion, and others) associated with cervical lymph node metastases.ResultsThe metastasis rates in the central and lateral compartments were 46.2% (30/65) and 40.0% (26/65), respectively. The incidence of cervical lymph node metastases was significantly higher in patients with a tumor size of >1 cm, tumor multifocality, and thyroid capsule invasion. Only thyroid capsule invasion was an independent predictive factor for central compartment metastases and lateral neck metastases. The possibility of central compartment metastases was significantly higher when the preoperative serum carcinoembryonic antigen concentration was >30 ng/mL (60.0% vs. 34.3%).ConclusionsMTC is associated with a high incidence of cervical lymph node metastases. Prophylactic lateral node dissection is necessary in patients with thyroid capsule invasion or a high serum carcinoembryonic antigen concentration.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of risk factors for cervical lymph node metastases in patients with sporadic medullary thyroid carcinoma

Fan

Cheng

2018

J Int Med Res

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“…This explains the increased postoperative hypocalcemia after a central neck dissection in association with a bilateral thymectomy with resection or devascularization of the inferior parathyroid glands with or without autotransplantation [4–7]. Some authors perform unilateral thymectomy (leaving the contralateral thymus and paratracheal tissue) in patients with a preoperative diagnosis of unilateral thyroid cancer in order to minimize this complication [6, 8]. Our aim was to study the benefit/risk (incidence of thymic lymph node metastases versus postoperative hypocalcemia) of bilateral versus unilateral (ipsilateral) thymectomy during total thyroidectomy with central compartment lymph node dissection for differentiated thyroid cancer.…”

Section: Introductionmentioning

confidence: 99%