Pattern of Nodal Metastases in Papillary Thyroid Carcinoma

Objective: The objective of this study is to determine the pattern of nodal metastases of papillary thyroid carcinoma to regional lymph in patients who have clinically positive nodes. Study design: Cross sectional study. Methods: Between January 2008 and December 2009, a total of 50 consecutive patients (15 male and 35 female) with clinical evidence of cervical lymph node metastases of papillary thyroid carcinoma was analyzed. Patients those with previous neck dissection for non thyroid malignancies and those neck node with follicular and medullary thyroid carcinoma were excluded from the study. Results: The predominant site of metastases was level III (82%), followed by level IV (62%), level II (48%), level VI (18%) and level V (16%). So, patients in the anterolateral group (level II, III and IV) were the greatest risk of metastatic disease, with level III nodes consistently the most frequently involved. No patient exhibited in level I involvement, multiple level involvement was found in 74% (37 of 50) patients. Conclusion: The high incidence of metastatic disease found in level III and IV. The level V and VI involvement were also reasonably high. Which supports the recommendation for posterolateral and anterior neck dissection for patients with papillary thyroid carcinoma with clinically positive nodes. DOI: http://dx.doi.org/10.3329/bjo.v19i1.14862 Bangladesh J Otorhinolaryngol 2013; 19(1): 46-52

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Correction to: Total thyroidectomy with therapeutic level II–IV neck dissection for papillary thyroid carcinoma: level VI recurrence patterns

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-06248-5 ◽

2020 ◽

Vol 277 (12) ◽

pp. 3457-3457

Author(s):

Narin N. Carmel-Neiderman ◽

Irit Duek ◽

Dana Amsterdam ◽

Anat Wengier ◽

Boris Kuzmenko ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Papillary Thyroid ◽

Therapeutic Level ◽

Level Ii ◽

Recurrence Patterns

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Prophylactic Level II Neck Dissection Guided by Frozen Section for Clinically Node-Negative Papillary Thyroid Carcinoma: Is It Useful?

World Journal of Surgery ◽

10.1007/s00268-013-2316-y ◽

2013 ◽

Vol 38 (3) ◽

pp. 667-672 ◽

Cited By ~ 3

Author(s):

Dana M. Hartl ◽

Abir Al Ghuzlan ◽

Isabelle Borget ◽

Sophie Leboulleux ◽

Haïtham Mirghani ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Neck Dissection ◽

Frozen Section ◽

Papillary Thyroid ◽

Node Negative ◽

Level Ii

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Total thyroidectomy with therapeutic level II–IV neck dissection for papillary thyroid carcinoma: level VI recurrence patterns

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-06079-4 ◽

2020 ◽

Vol 277 (12) ◽

pp. 3449-3455

Author(s):

Narin N. Carmel-Neiderman ◽

Irit Duek ◽

Dana Amsterdam ◽

Anat Wengier ◽

Boris Kuzmenko ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Papillary Thyroid ◽

Therapeutic Level ◽

Level Ii ◽

Recurrence Patterns

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Level V Clearance in Neck Dissection for Papillary Thyroid Carcinoma: A Need for Homogeneous Studies

International Archives of Otorhinolaryngology ◽

10.1055/s-0037-1608909 ◽

2017 ◽

Vol 22 (04) ◽

pp. 449-454 ◽

Cited By ~ 1

Author(s):

Azhar Battoo ◽

Zahoor Sheikh ◽

Krishnakumar Thankappan ◽

Abdul Mir ◽

Altaf Haji

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Neck Dissection ◽

High Rate ◽

Current Evidence ◽

Lateral Neck ◽

Papillary Thyroid ◽

Neck Disease ◽

Level Ii ◽

The Impact

Introduction Papillary thyroid carcinoma has a very high rate of lateral neck node metastases, and there is almost unanimity concerning the fact that some sort of formal neck dissection must be performed to address the clinical neck disease in these cases. Although there is an agreement that levels II to IV need to be cleared in these patients, the clearance of level V is debatable. Objectives We herein have tried to analyze various papers that have documented a structured approach to neck dissection in these patients. Moreover, we have also tried to consider this issue through various aspects, like spinal accessory nerve injury and the impact of neck recurrence on survival. Data Synthesis The PubMed, Medline, Google Scholar, Surveillance, Epidemiology, and End Results (SEER), and Ovid databases were searched for studies written in English that focused on lateral neck dissection (levels II–IV or II–V) for papillary thyroid carcinoma. Case reports with 10 patients or less were excluded. Conclusions The current evidence is equivocal whether to clear level V or not, and the studies published on this issue are very heterogeneous. Level II-IV versus level II-V selective neck dissections in node-positive papillary thyroid carcinoma patients is far from categorical, with pros and cons for both approaches. Hence, we feel that there is a need for more robust homogeneous data in order to provide an answer to this question.

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