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KMID : 0371420180940050229
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Annals of Surgical Treatment and Research
2018 Volume.94 No. 5 p.229 ~ p.234
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Extent of central lymph node dissection for papillary thyroid carcinoma in the isthmus
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Chang Young-Woo
Lee Hye-Yoon
Kim Hwan-Soo
Kim Hoon-Yub
Lee Jae-Bok
Son Gil-Soo
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Abstract
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Purpose: The incidence of papillary thyroid carcinoma (PTC) arising from the isthmus is low; however, these tumors have aggressive clinical and pathological features. Moreover, the existing guidelines regarding the extent of surgery for this type of tumor are unclear.
Methods: This study enrolled 282 patients who underwent total thyroidectomy with bilateral central lymph node dissection. The patients were divided into 2 groups based on the location of the median line of the PTC. Group I included patients in whom the median line was located between the lateral margins of the trachea; group II included all others. We compared the 2 groups and conducted a multivariate analysis to assess risk factors for contralateral node metastasis from a PTC arising from the isthmus.
Results: Patients in group I had significantly higher frequencies of extrathyroidal extension and central lymph node metastasis. Group I also had a higher frequency of contralateral node metastasis, and a tumor size >1.0 cm was identified as an independent risk factor for contralateral node metastasis among patients in this group.
Conclusion: Bilateral central lymph node dissection could be considered for patients with isthmic PTCs >1.0 cm in size who have clinically suspicious node metastasis.
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KEYWORD
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Papillary thyroid carcinoma, Papillary thyroid microcarcinoma, Lymph node excision
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