scholarly journals An Approach to Macroscopic Central Lymph Nodes Detected during Surgery in Patients with Thyroid Micropapillary Carcinoma: Should We Resort to Dissection?

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Osman Kurukahvecioglu ◽  
Kursat Dikmen ◽  
Hasan Bostanci ◽  
Murat Akin ◽  
Ferit Taneri
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Tumor Size ◽  
Node Dissection ◽  
Micropapillary Carcinoma ◽  
Central Lymph Node ◽  
Lymphocytic Thyroiditis ◽  
Central Lymph Node Dissection ◽  
Central Lymph

Background. High-resolution ultrasonography and the ability to perform fine-needle aspiration biopsy even for nodules smaller than three millimeters have considerably increased the detection rate of thyroid micropapillary carcinoma (TMPC). Despite favorable prognosis, the prevalence of cervical lymph node metastases in patients with TMPC is approximately 30%. Aim. In this study, we aimed to determine the central lymph node metastasis rate and its relation to the characteristics of the tumor. Methods. One hundred nine patients who underwent surgery due to TMPC between December 2009 and January 2014 were analyzed retrospectively. Patients were divided into two groups according to whether they underwent lymph node dissection and the two groups were then compared with respect to tumor size and multicentricity, age, and presence of lymphocytic thyroiditis. Results. There were no statistically significant differences between the two groups of patients in terms of tumor size, tumor multicentricity, age, and presence of lymphocytic thyroiditis. When the patient group that received lymph node dissection was further analyzed, it was found that patients with lymphocytic thyroiditis had a significantly lower number of metastatic lymph nodes. Conclusion. Central lymph node dissection in TMPC patients with macroscopic lymph node detected intraoperatively would ensure accurate staging without an increase in morbidity.

scholarly journals THE IMPACT OF ELECTIVE CENTRAL LYMPH NODE DISSECTION ON POSTOPERATIVE PATHOLOGICAL STAGING AND SURGICAL COMPLICATION RATE IN PATIENTS WITH RESULTS OF FINE NEEDLE ASPIRATION BIOPSY SUSPICIOUS FOR FOLLICULAR NEOPLASM OF THYROID

2020 ◽  
Vol 73 (4) ◽  
pp. 629-637
Author(s):  
Jarosław Świrta ◽  
Michał Romaniszyn ◽  
Marcin Barczyński
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Follicular Adenoma ◽  
Follicular Neoplasm ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Early Postoperative Complications ◽  
Central Lymph

Introduction: Follicular-patterned lesions of the thyroid are common; these include follicular adenoma, follicular cancer and follicular variant of papillary cancer. At present, preoperative discrimination between follicular adenoma and follicular cancer is infeasible and most patients require surgery to confirm diagnosis. The aim: To assess the impact of elective central lymph node dissection on postoperative pathological staging and early surgical complication rate in patients operated for suspicion for follicular neoplasm or suspicion for oxyphilic neoplasm of thyroid. Materials and Methods: Eighty consecutive patients operated between 2016–2018 in Third Department of General Surgery UJCM because of suspicious for follicular neoplasm of the thyroid were included into the study. Inclusion criteria were: the result of fine needle aspiration biopsy “ suspicious for follicular/oxyphilic neoplasm”, absence of invasive neoplasm features as follows infiltration of surrounding tissue or lymph nodes/distant metastases, informed consent. In all patients elective central lymph node dissection was performed. Surgical early postoperative complications were reported and the rate was compared between the study group and the control group consisting of patients operated on in the same period for benign nodular goitre.Results: In 10 (12,5%) patients thyroid cancer was diagnosed, including 8 (80%) patients with papillary cancer and 2 (20%) patients with follicular cancer. The most common benign lesion was follicular adenoma diagnosed in 42 (60%) patients. There were 129 lymph nodes dissected (mean 1.6 lymph node per 1 patient), all lymph nodes were clear of cancer cells. In 26 patients there were no lymph nodes in postoperative preparation. Metastatic lymph nodes were not identified in any patients of the study group with final diagnosis of thyroid cancer. No significant differences were identified in prevalence of early postoperative complications among the study group and the control group patients: unilateral recurrent laryngeal nerve (RLN) palsy 3.4% vs. 1.49%; p= 0,08), hypocalcemia (5% vs. 5.4%; p=0.86), postoperative hemorrhage (1.25% vs. 0.44; p=0.29).Conclusions: Elective central lymph node dissection at experienced surgical hands does not improve postoperative pathological staging and is not associated with higher risk of early postoperative complications.

Extent of Routine Central Lymph Node Dissection With Small Papillary Thyroid Carcinoma

2007 ◽  
Vol 31 (10) ◽  
pp. 1954-1959 ◽  
Author(s):  
Yong Sang Lee ◽  
Seok Won Kim ◽  
Sun Wook Kim ◽  
Seok Ki Kim ◽  
Han-Sung Kang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Central Lymph

scholarly journals Clinical Analysis of Cervical Lymph Node Metastasis Risk Factors and the Feasibility of Prophylactic Central Lymph Node Dissection in Papillary Thyroid Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yifan Chen ◽  
Shuo Chen ◽  
Xiaoying Lin ◽  
Xiangqing Huang ◽  
Xiaofang Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Cervical Lymph Node Metastasis ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Objective. To identify the risk factors for cervical lymph node metastasis (CLNM) and the feasibility of prophylactic central lymph node dissection. Methods. The characteristics of 1107 patients were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with lymph node metastasis. The relationship between the central lymph node dissection (CLND) and lateral lymph node metastasis (LLNM) was analyzed using the correlation analysis. Results. The probability of CLNM was closely related to the male gender, age <55, and the increase of tumor size. Those patients with an increase in tumor size and CLNM were extremely prone to LLNM. Also, LLNM was more likely to happen in those with the more positive central lymph nodes. Routine prophylactic central lymph node dissection (P-CLND) did not increase the risk of complications. Conclusion. P-CLND should be considered as a reasonable surgical treatment for PTC.

scholarly journals Prophylactic Bilateral Central Neck Dissection Should Be Evaluated Based on Prospective Study of 581 PTC Patients

2021 ◽  
Author(s):  
Shouyi YAN ◽  
Jiafan Yu ◽  
wenxin zhao ◽  
Bo WANG ◽  
Liyong ZHANG
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Test Group ◽  
Control Group ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Abstract Background: Prophylactic central lymph node dissection (PCND) had been a basic consensus for patients with papillary thyroid carcinoma in China. However, unilateral or bilateral central lymph node dissection (CND)was still controversial. This study aimed at investigating the safety and long-term benefit for the patients with bilateral central lymph node dissection (BCCD). Methods: 581 patients were enrolled and divided randomly into the test and control groups according to a different range of CND. 285 patients were prospectively assigned to undergo lobe thyroidectomy plus BCND in the test group, in comparison 296 patients were assigned to undergo lobe thyroidectomy plus ipsilateral central lymph node dissection (ICND) in the control group. Results: We found that the numbers of total LN and N1a in the test group were higher than that of the control group (p=0.002), but there was no difference in the number of metastasized lymph nodes (p=0.857) and tumor recurrence (p=0.308). Additionally, in the aspect of postoperative complication (1 day after surgery), the serum levels of parathyroid hormone in the BCND group were lower than that in the ICND group (P =0.010), and the numbers of transient laryngeal nerve palsy were higher than that(p=0.033). meanwhile we further found that tumors size larger than 1cm and tumor side lymph node metastasis were related to the contralateral lymph node metastasis. Conclusion: BCND resulted in more positive lymph nodes and complications while did not change the patient's long-term prognosis. It may be an alternative for patients with tumor sizes larger than 1cm in large medical centers.

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