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KMID : 1202020140070020129
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Journal of Korean Thyroid Association
2014 Volume.7 No. 2 p.129 ~ p.135
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Regional Lymph Node Metastasis in Papillary Thyroid Cancer
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Park Jae-Hyun
Lee Kang-San
Bae Keum-Seok
Kang Seong-Joon
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Abstract
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Papillary thyroid cancer is a common endocrine cancer and commonly presents with lymph node metastases.It has been generally accepted that lymphatic drainage occurs from the thyroid primarily to the centrallymphatic compartment and secondarily to the lateral compartment nodes. Recently, improvements in theresolution of imaging studies and the availability of highly sensitive thyroglobulin assays have highlighted theimportance of identifying disease in the pre-operative assessment and dealing effectively with metastaticregional disease in order to prevent recurrence. However, there are limitations to diagnosing central lymphnode metastases. With unreliable imaging modalities, prophylactic central lymph node dissection should beperformed on all patients with papillary thyroid cancer. In comparison with the central compartment,prophylactic lateral node dissection has little or no effect on improving the prognosis of patients with papillarythyroid cancer. Therefore, lateral node dissection is recommended only as a part of the therapeutic procedure.The extension of lateral neck dissection is recommended a comprehensive selective neck dissection of levelsIIa, III, IV, and Vb. The rich lymphatic supply of the thyroid gland coupled with the propensity for nodalmetastases in papillary thyroid cancer require the modern thyroid surgeon to be familiar with the indicationsfor and techniques of regional lymph node dissection.
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KEYWORD
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Papillary thyroid cancer, Lymph node, Metastasis, Central compartment, Lateral neck
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