Patterns of Lateral Neck Metastasis in Papillary Thyroid Carcinoma

Abstract

Background: Although lymphatic metastasis does not affect overall survival for patients with differentiated thyroid carcinoma, locoregional control can be improved with cervical lymphadenectomy. The major morbidity of neck dissection (ND) for the management of regional metastases is spinal accessory (cranial nerve XI) dysfunction. To avoid this complication, some surgeons have advocated a limited ND.Objective: To establish the patterns of lateral cervical metastases in differentiated thyroid carcinoma and the role of comprehensive ND, we performed a review of our experience with comprehensive ND.

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

“…For those patients in whom nodal disease is evident clinically, on preoperative ultrasound, or at the time of surgery, surgical resection may reduce the risk of recurrence and possibly mortality (102,109,110). Functional compartmental en-bloc dissection is favored over selective dissection (berry picking) with limited data suggesting improved mortality (64,(111)(112)(113).…”

Shorter Distance Between the Nodule and Capsule has Greater Risk of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma

“…A large number of studies report that the initial lymph node is involved in 30-90% of patients, and it is revealed by pathologic examination that there were high rates of central CLNM (57.9%) and lateral CLNM (25.6%) in patients with PTC (Kupferman et al, 2004;Caron et al, 2005;Roh et al, 2009). Patients with CLNM have an increased chance of recurrence and a low survival rate (Beasley et al, 2002;Mazzaferri et al, 2003;Machens et al, 2003;Lundgren et al, 2006;Ito et al, 2009;Rotstein, 2009).…”

Radioiodine Scintigraphy with SPECT/CT: An Important Diagnostic Tool for Thyroid Cancer Staging and Risk Stratification

“…Initial therapy for thyroid cancer includes near-total or total thyroidectomy with or without prophylactic or therapeutic central compartment neck dissection to remove the primary tumor and involved cervical lymph nodes (5). Therapeutic lateral neck compartmental dissection is performed for patients with metastatic lateral cervical lymphadenopathy (6)(7)(8). Cervical nodal metastases are present in 20%-50% of patients at the time of diagnosis, even with small intrathyroidal tumors (microcarcinomas) (9)(10)(11)(12).…”