Relevant Factors Analysis of LevelⅡLymphatic Metastasis in Papillary Thyroid Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LüCheng-zhou , DONGWen-wu , HELiang , ZHANGDa-lin , JIAAi-qing ,  ZHANGHao

Department of General Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China;

Corresponding?author：

ZHANGHao, Email: haozhang@mail.cmu.edu.cn

Keywords：

Papillary thyroid carcinoma; Lymphatic metastasis; Neck dissection

DOI：

10.7507/1007-9424.20150049

Video：

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Objective To analyze the relevant factors of levelⅡlymph node metastasis in papillary thyroid carci-noma. Methods The clinicopathologic data of 83 patients from November 2011 to March 2014 were analyzed retrospec-tively. All the primary tumors were papillary thyroid carcinoma located in unilateral lobe with ipsilateral lateral neck lymph node metastasis. The relationship of gender, age, microcarcinoma, superior pole involved by carcinoma, integrated tumor capsule, or extranodal invasion to levelⅡlymph node metastasis was analyzed. The calculated data were analyzed with Chi-Square test and there was significant difference when P < 0.05. Results The rate of lymph node metastasis at levelⅡ, Ⅲ, Ⅳ, Ⅴ, Ⅵwas 51.8% (43/83), 78.3% (65/83), 71.7% (59/83), 4.8% (4/56), and 79.5% (66/83), respectively. There was no significant relationship of gender, age, microcarcinoma, integrated tumor capsule, or extranodal invasion to levelⅡlymph node metastasis (P > 0.05). The rate of lymph node metastasis at levelⅡwas significantly higher when superior pole involved by carcinoma (P < 0.05). Conclusion Among the patients with papillary thyroid carcinoma, when superior pole involved by carcinoma the patient should be underwent selective neck dissection, the proper extent of dissection including levelⅡshould be performed.

Citation： LüCheng-zhou, DONGWen-wu, HELiang, ZHANGDa-lin, JIAAi-qing, ZHANGHao. Relevant Factors Analysis of LevelⅡLymphatic Metastasis in Papillary Thyroid Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(2): 177-180. doi: 10.7507/1007-9424.20150049 Copy

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2.	Sivanandan R, Soo KC. Pattern of cervical lymph node metastases from papillary carcinoma of the thyroid. Br J Surg, 2001, 88(9): 1241-1244.
3.	Mazzaferri EL, Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab, 2001, 86(4): 1447-1463.
4.	Moo TA, Mcgill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg, 2010, 34(6): 1187-1191.
5.	鄢丹桂, 張彬, 安常明, 等.甲狀腺乳頭狀癌臨床N0患者頸部淋巴結轉移規律.中華耳鼻咽喉頭頸外科雜志, 2011, 46(11): 887-891.
6.	張強, 張侖, 宋方方, 等.甲狀腺乳頭狀癌頸部淋巴結轉移規律臨床分析.中國耳鼻咽喉頭頸外科, 2010, 17(12): 639-642.
7.	諸林海, 丁向民.甲狀腺乳頭狀癌Ⅵ區陽性淋巴結數與清除方式的選擇.中國現代普通外科進展, 2009, 12(7): 576-579.
8.	曾瑞超, 黃慧雅, 李權, 等.甲狀腺乳頭狀微小癌頸側區淋巴結轉移相關因素分析.中華內分泌代謝雜志, 2012, 28(3): 207-210.
9.	張夢萍, 張詮, 郭朱明, 等.乳頭狀甲狀腺癌側頸淋巴結隱匿性轉移相關因素分析.中華臨床醫師雜志:電子版, 2012, 6(13): 100-102.
10.	張瀏陽, 周旋, 姚曉峰, 等.甲狀腺乳頭狀癌Ⅱ區淋巴結隱匿性轉移的臨床分析.中華耳鼻咽喉頭頸外科雜志, 2011, 46(9): 733-737.
11.	Davidson HC, Park BJ, Johnson JT. Papillary thyroid cancer: controversies in the management of neck metastasis. Laryngoscope, 2008, 118(12): 2161-2165.
12.	Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med, 1994, 97(5): 418-428.
13.	Cappiello J, Piazza C, Nicolai P. The spinal accessory nerve in head and neck surgery. Curr Opin Otolaryngol Head Neck Surg, 2007, 15(2): 107-111.
14.	宋軍健.甲狀腺乳頭狀腺癌選擇性頸清掃術后并發癥.中國耳鼻咽喉頭頸外科, 2007, 14(6): 331-333.
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16.	National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 1. 2010). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
17.	National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 1. 2011). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
18.	Caron NR, Tan YY, Ogilvie JB, et al. Selective modified radical neck dissection for papillary thyroid cancer-is levelⅠ, Ⅱand V dissection always necessary? World J Surg, 2006, 30(5): 833-840.
19.	National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 2. 2012). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
20.	Patron V, Bedfert C, Le Clech G, et al. Pattern of lateral neck metastases in N0 papillary thyroid carcinoma. BMC Cancer, 2011, 11: 8.
21.	Palazzo FF, Gosnell J, Savio R, et al. Lymphadenectomy for papillary thyroid cancer: changes in practice over four decades. Eur J Surg Oncol, 2006, 32(3): 340-344.
22.	葛明華, 王可敬, 劉愛華.無區域淋巴結轉移甲狀腺乳頭狀癌患者的頸部處理.中國腫瘤臨床, 2001, 28(4): 254-256.
23.	中華醫學會內分泌學分會, 中華醫學會外科學分會, 中國抗癌協會頭頸腫瘤專業委員會, 中華醫學會核醫學分會.甲狀腺結節和分化型甲狀腺癌診治指南.中國腫瘤臨床, 2012, 39(17): 1249-1272.
24.	朱精強.分化型甲狀腺癌頸淋巴結清掃的相關問題.中國普外基礎與臨床雜志, 2012, 19(8): 809-813.

1. ?Mazzaferri EL, Massoll N. Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin. Endocr Relat Cancer, 2002, 9(4): 227-247.
2. Sivanandan R, Soo KC. Pattern of cervical lymph node metastases from papillary carcinoma of the thyroid. Br J Surg, 2001, 88(9): 1241-1244.
3. Mazzaferri EL, Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab, 2001, 86(4): 1447-1463.
4. Moo TA, Mcgill J, Allendorf J, et al. Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma. World J Surg, 2010, 34(6): 1187-1191.
5. 鄢丹桂, 張彬, 安常明, 等.甲狀腺乳頭狀癌臨床N0患者頸部淋巴結轉移規律.中華耳鼻咽喉頭頸外科雜志, 2011, 46(11): 887-891.
6. 張強, 張侖, 宋方方, 等.甲狀腺乳頭狀癌頸部淋巴結轉移規律臨床分析.中國耳鼻咽喉頭頸外科, 2010, 17(12): 639-642.
7. 諸林海, 丁向民.甲狀腺乳頭狀癌Ⅵ區陽性淋巴結數與清除方式的選擇.中國現代普通外科進展, 2009, 12(7): 576-579.
8. 曾瑞超, 黃慧雅, 李權, 等.甲狀腺乳頭狀微小癌頸側區淋巴結轉移相關因素分析.中華內分泌代謝雜志, 2012, 28(3): 207-210.
9. 張夢萍, 張詮, 郭朱明, 等.乳頭狀甲狀腺癌側頸淋巴結隱匿性轉移相關因素分析.中華臨床醫師雜志:電子版, 2012, 6(13): 100-102.
10. 張瀏陽, 周旋, 姚曉峰, 等.甲狀腺乳頭狀癌Ⅱ區淋巴結隱匿性轉移的臨床分析.中華耳鼻咽喉頭頸外科雜志, 2011, 46(9): 733-737.
11. Davidson HC, Park BJ, Johnson JT. Papillary thyroid cancer: controversies in the management of neck metastasis. Laryngoscope, 2008, 118(12): 2161-2165.
12. Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med, 1994, 97(5): 418-428.
13. Cappiello J, Piazza C, Nicolai P. The spinal accessory nerve in head and neck surgery. Curr Opin Otolaryngol Head Neck Surg, 2007, 15(2): 107-111.
14. 宋軍健.甲狀腺乳頭狀腺癌選擇性頸清掃術后并發癥.中國耳鼻咽喉頭頸外科, 2007, 14(6): 331-333.
15. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 1. 2009). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
16. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 1. 2010). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
17. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 1. 2011). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
18. Caron NR, Tan YY, Ogilvie JB, et al. Selective modified radical neck dissection for papillary thyroid cancer-is levelⅠ, Ⅱand V dissection always necessary? World J Surg, 2006, 30(5): 833-840.
19. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid carcinoma (Version 2. 2012). http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf.
20. Patron V, Bedfert C, Le Clech G, et al. Pattern of lateral neck metastases in N0 papillary thyroid carcinoma. BMC Cancer, 2011, 11: 8.
21. Palazzo FF, Gosnell J, Savio R, et al. Lymphadenectomy for papillary thyroid cancer: changes in practice over four decades. Eur J Surg Oncol, 2006, 32(3): 340-344.
22. 葛明華, 王可敬, 劉愛華.無區域淋巴結轉移甲狀腺乳頭狀癌患者的頸部處理.中國腫瘤臨床, 2001, 28(4): 254-256.
23. 中華醫學會內分泌學分會, 中華醫學會外科學分會, 中國抗癌協會頭頸腫瘤專業委員會, 中華醫學會核醫學分會.甲狀腺結節和分化型甲狀腺癌診治指南.中國腫瘤臨床, 2012, 39(17): 1249-1272.
24. 朱精強.分化型甲狀腺癌頸淋巴結清掃的相關問題.中國普外基礎與臨床雜志, 2012, 19(8): 809-813.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relevant Factors Analysis of LevelⅡLymphatic Metastasis in Papillary Thyroid Carcinoma

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