TY - JOUR
T1 - Therapeutic lateral neck dissection in well-differentiated thyroid cancer: Analysis on factors predicting distribution of positive nodes and prognosis
AU - Lombardi, D.
AU - Paderno, A.
AU - Giordano, D.
AU - Barbieri, D.
AU - Taboni, S.
AU - Piazza, C.
AU - Cappelli, C.
AU - Bertagna, F.
AU - Barbieri, V.
AU - Piana, S.
AU - Bellafiore, S.
AU - Spriano, G.
AU - Mercante, G.
AU - Nicolai, P.
N1 - LR: 20170930; CI: (c) 2017; JID: 8902541; OTO: NOTNLM; 2017/01/13 [received]; 2017/07/10 [revised]; 2017/07/27 [accepted]; aheadofprint
PY - 2018/2
Y1 - 2018/2
N2 - 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.
AB - 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.
KW - lateral neck metastases
KW - neck dissection
KW - neck levels
KW - survival
KW - well-differentiated thyroid cancer
U2 - 10.1002/hed.24936 [doi]
DO - 10.1002/hed.24936 [doi]
M3 - Article
JO - Head and Neck Surgery
JF - Head and Neck Surgery
SN - 1043-3074
ER -