Therapeutic lateral neck dissection in well-differentiated thyroid cancer: Analysis on factors predicting distribution of positive nodes and prognosis

Davide Lombardi, Alberto Paderno, Davide Giordano, Diego Barbieri, Stefano Taboni, Cesare Piazza, Carlo Cappelli, Francesco Bertagna, Verter Barbieri, Simonetta Piana, Salvatore Bellafiore, Giuseppe Spriano, Giuseppe Mercante, Piero Nicolai

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BACKGROUND: Neck dissection is considered the treatment of choice in patients with lateral neck metastases from well-differentiated thyroid cancer.

METHODS: A multicenter, retrospective review of patients who underwent therapeutic lateral neck dissection for well-differentiated thyroid carcinoma was carried out.

RESULTS: The study included a total of 405 lateral neck dissections performed in 352 patients; 197 women (56%) and 155 men (44%). When considering ipsilateral neck metastases, levels IIa, IIb, III, IV, Va, Vb, and V (not otherwise specified) were involved in 42%, 6%, 73%, 67%, 11%, 31%, and 35% of cases, respectively. Five-year and 10-year overall survival (OS) were 93% and 81%, respectively. Age >55 years, pathologic T (pT)4 category, tumor diameter >4 cm, aggressive variants of well-differentiated thyroid carcinoma, endovascular invasion, and number of positive nodes >5 turned out to be the most important prognostic factors.

CONCLUSION: Neck dissection is a valid treatment option in the presence of neck metastasis from well-differentiated thyroid carcinoma. Levels IIa, III, IV, and Vb should always be removed.

Original languageEnglish
JournalHead and Neck Surgery
Issue number2
Publication statusE-pub ahead of print - Sep 30 2017



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