유두상 갑상선 암에서 측경부 림프절 전이패턴 및 5구역 전이 예측Pattern of Lateral Neck Metastasis and Predictors of Level V Metastasis in Papillary Thyroid Carcinoma
- Other Titles
- Pattern of Lateral Neck Metastasis and Predictors of Level V Metastasis in Papillary Thyroid Carcinoma
- Authors
- 김태령; 이영돈; 박흥규; 정유승; 구소령
- Issue Date
- Sep-2011
- Publisher
- 대한갑상선-내분비외과학회
- Keywords
- Papillary thyroid carcinoma; Lateral neck node metastasis; Modified radical neck node dissection; Level V metastases; 유두상 갑상선암; 측경부 림프절 전이; 변형근치적 림프절제술; 5구역 림프절 전이
- Citation
- The Journal of Endocrine Surgery, v.11, no.3, pp.164 - 168
- Journal Title
- The Journal of Endocrine Surgery
- Volume
- 11
- Number
- 3
- Start Page
- 164
- End Page
- 168
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/41969
- ISSN
- 2508-8149
- Abstract
- Purpose: Cervical lymphadenectomy is frequently performed in patients with lateral cervical lymph node metastasis to improve regional control of disease. However, there is controversy regarding appropriate levels of the neck that need to be dissected. In particular, the routine dissection of level V remains an annoying and time consuming procedure due to the injury of the spinal accessory nerve.
Methods: To identify clinical and pathological predictors of cervical node metastases to level V in papillary thyroid carcinoma, we analyzed 42 patients who underwent modified radical neck dissection (MRND), which were separately performed by each strict anatomical level. Five patients underwent both MRND, 29 patients received total thyroidectomy with central neck node dissection and MRND at the time of initial operation. Thirteen patients underwent MRND later when lateral neck metastases were found at the follow-up after total thyroidectomy with central neck node dissection.
Results: In our series, 11.9% of neck specimens harbored metastatic thyroid carcinoma at level V. The metastatic rate of level II, III, and IV was 54.7%, 85.7%, and 64.2%, respectively. The presence of level V metastases was not significantly associated with level II, III metastases, age, sex, and histopathologic findings. But, it seemed to be associated with level IV metastases if the proportion of metastasis of level IV exceeded 50%.
Conclusion: Cervical node metastasis seems to be associated with level IV metastases if the proportion of metastasis of level IV exceeds 50%. (Korean J Endocrine Surg 2011;11:164-168)
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