Korean J Otorhinolaryngol-Head Neck Surg.  2017 Mar;60(3):125-134. 10.3342/kjorl-hns.2016.17335.

The Factors Involved in Bilateral Central Lymph Node Metastasis of Isthmus Papillary Thyroid Cancer

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
  • 2Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. ljc0209@hanmail.net

Abstract

BACKGROUND AND OBJECTIVES
The aims of this study were to evaluate the rate and risk factors involved in bilateral central lymph node metastasis in patients with papillary thyroid cancer (PTC) found in the isthmus and compared them to tumors located in other thyroid regions, using those findings to establish a surgical strategy for treating these tumors. SUBJECTS AND METHOD: We compared the clinical and pathological data of 48 patients with isthmic PTC and 141 patients with PTC found in other thyroid regions, all of whom underwent total thyroidectomy and bilateral central neck dissection.
RESULTS
The rates of bilateral central lymph node metastasis were higher in the isthmus group than in the non-isthmus group (29.2% vs. 9.9%; p=0.001). On multivariate analysis, the isthmic location of the tumor was an independent risk factor for bilateral central lymph node metastasis (OR=3.458; p=0.005). But the positional relationship between the tracheal midline and the nodule was not clear in lymph node metastasis in the isthmus group.
CONCLUSION
Bilateral central neck dissection should be considered for isthmic PTC regardless of the relation between nodule and tracheal midline because of the high rate of bilateral central lymph node metastasis.

Keyword

Lymphatic metastasis; Neck dissection; Papillary thyroid carcinoma; Thyroid gland
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