Significance of mediastinal lymph node metastases in carcinoma of the thyroid

Block, Melvin A.; Miller, Joanne L.; Horn, Robert C.

doi:10.1016/0002-9610(72)90358-3

Cited by 31 publications

(27 citation statements)

References 3 publications

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“…The route may also flow adjacent to the contralateral nodes and through the central nodes. This ultimately results in mediastinal LN metastasis [18,19].…”

Section: Discussionmentioning

confidence: 99%

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Impact of superior mediastinal metastasis on the prognosis of papillary thyroid carcinoma

Moritani

2016

Endocr J

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“…The route may also flow adjacent to the contralateral nodes and through the central nodes. This ultimately results in mediastinal LN metastasis [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of mediastinal metastasis has been reported to range from 2.7% to 22% [3,7,[19][20][21]. The frequency of mediastinal metastases in patients with clinical cervical metastasis was higher [5,7,22].…”

Section: Discussionmentioning

confidence: 99%

Impact of superior mediastinal metastasis on the prognosis of papillary thyroid carcinoma

Moritani

2016

Endocr J

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“…In this study, 49.4% of the patients had cervical lymph node metastases. Most series have reported a higher rate of nodal disease in the central compartment and lateral neck than in the mediastinum [7,19]; however, right upper paraesophageal lymph node metastasis posterior to the right recurrent laryngeal nerve is associated with superior mediastinal lymph node metastasis and is a risk for invasion of the mediastinal organs, including the trachea [20,21]. Because it has been associated with a high risk of postoperative hypocalcemia [22], there are currently reduced numbers of indications for elective right upper paraesophageal lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of right upper paraesophageal lymph node metastasis from papillary thyroid carcinoma

Kim

Park

2012

World J Surg Onc

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BackgroundCentral and lateral lymph node metastases are quite common in patients with papillary thyroid carcinoma, and the predictors for those metastases have been well studied. Right upper paraesophageal lymph node metastasis has rarely been studied. The aim of this study was to identify the clinicopathological characteristics that may be risk factors for right upper paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma.MethodsThis was a prospective observational study of 243 patients with papillary thyroid carcinoma (PTC) who underwent total thyroidectomy and comprehensive central lymph node dissection with or without lateral lymph node dissection between April 2008 and January 2010. The clinicopathologic findings from these patients were investigated and the patterns of lymph node metastasis were analyzed in the patients who had right upper paraesophageal lymph node disease.ResultsOf the 243 patients undergoing lymph node dissection, 14 had right upper paraesophageal lymph node metastases. Two of these patients had right upper paraesophageal lymph node metastasis only, without central compartment metastasis. Univariate analysis of clinicopathologic findings showed that right upper paraesophageal lymph node metastasis had significant association with larger primary tumors, multifocal tumors, extrathyroid extension, and lymphatic invasion (p <0.05 for each factor).ConclusionsAlthough there were no independent predictors of right upper paraesophageal lymph node metastasis, it can be the only site of metastasis without other compartmental metastasis. Therefore, during surgery for patients with central or lateral lymph node metastases from PTC, it may be helpful to examine the right upper paraesophageal lymph nodes.

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“…Putting in mind that in PTC, lymph node metastases have been shown to increase the risk of locoregional tumor recurrence (Hay et al, 1999;Leboulleux et al, 2005;Cheema et al, 2006;Ito and Miyauchi, 2007) and that approximately 5% of patients with PTC were identified as having superior mediastinal metastases (Roh et al, 2008;Machens and Dralle, 2009) with concerns that metastatic lymph node involvement is nothing more than indolent microscopic disease without clinical significance and that the sensitivity of ultrasound and CT range between only 50 and 70 % Mulla, (2012), and on the other hand Wang et al, 2013 advocated the unnecessary CND in some patients with incidental PTC postoperatively and that the impact of positive regional lymph nodes on survival has been controversial (Steinmuller et al, 2000), we performed a prophylactic CND including level VI and VII from the same collar neck incision (Block et al, 1972). Yu et al, 2012 recommended the "wait and see" strategy for clinically negative level V in low risk PTC patients and stated that it would still achieve good survival results.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Level VII Nodal Dissection as a Prognostic Factor in Papillary Thyroid Carcinoma: a Pilot Study of 27 Patients

Fayek

2015

Asian Pacific Journal of Cancer Prevention

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Background: Prognostic value of prophylactic level VII nodal dissection in papillary thyroid carcinoma has been highlighted. Materials and Methods: A total of 27 patients with papillary thyroid carcinoma with N0 neck underwent total thyroidectomy with level VI and VII nodal dissection through same collar neck incision. Multicentricity, bilaterality, extrathyroidal extension, level VI and VII lymph nodes were studied as separate and independent prognostic factors for DFS at 24 months. Results: 21 females and 6 males with a mean age of 34. Conclusions: Level VII prophylactic nodal dissection is an important and integral prognostic factor in papillary thyroid carcinoma. A larger multicenter study is crucial to reach a satisfactory conclusion about the necessity and safety of this approach.

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Significance of mediastinal lymph node metastases in carcinoma of the thyroid

Cited by 31 publications

References 3 publications

Impact of superior mediastinal metastasis on the prognosis of papillary thyroid carcinoma

Impact of superior mediastinal metastasis on the prognosis of papillary thyroid carcinoma

Clinical predictors of right upper paraesophageal lymph node metastasis from papillary thyroid carcinoma

Prophylactic Level VII Nodal Dissection as a Prognostic Factor in Papillary Thyroid Carcinoma: a Pilot Study of 27 Patients

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