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Relevance of level IIb neck dissection in patients with papillary thyroid carcinoma

Published online by Cambridge University Press:  23 February 2021

S Hosokawa ,
G Takahashi ,
J Okamura ,
A Imai ,
D Mochizuki ,
R Ishikawa ,
Y Takizawa ,
K Misawa ,
K Shinmura  and
H Mineta
S Hosokawa*
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
G Takahashi
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan Yamahoshi ENT Clinic, Hamamatsu, Japan
J Okamura
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan Department of Otorhinolaryngology, Seirei Hamamatsu General Hospital, Japan
A Imai
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
D Mochizuki
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
R Ishikawa
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
Y Takizawa
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
K Misawa
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
K Shinmura
Affiliation:
Department of Tumor Pathology, Hamamatsu University School of Medicine, Japan
H Mineta
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Japan
*
Author for correspondence: Dr Seiji Hosokawa, Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka431-3192, Japan E-mail: seijih@hama-med.ac.jp Fax: +81 53 435 2253
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Abstract

Background

Cervical nodal metastasis is a key prognostic factor in patients with papillary thyroid carcinoma. The role of lymph nodes in papillary thyroid carcinoma management and prognosis remains controversial.

Methods

Level IIb lymph nodes obtained from 44 patients with papillary thyroid carcinoma were histopathologically examined retrospectively. Specimens were classified as ipsilateral or contralateral. The number of dissected nodes and prevalence of level IIb metastasis were compared according to pre-operative clinical nodal stage.

Results

In the node-negative neck, the prevalence of contralateral and ipsilateral IIb nodes was 0 out of 20 and 0 out of 3, respectively. In the node-positive neck, the prevalence of contralateral and ipsilateral IIb nodes was 1 out of 13 (7.70 per cent) and 3 out of 41 (7.32 per cent), respectively. Clinically determined and pathologically confirmed level IIb node negativity were significantly associated. Thirty-four patients (77.3 per cent) developed accessory nerve complications from level IIb dissection.

Conclusion

Level IIb neck dissection for papillary thyroid carcinoma may be required if pre-operative examination reveals multilevel, level IIa or suspicious level IIb metastasis.

Keywords

Accessory NerveLymphatic MetastasisLymph NodesNeck DissectionThyroid Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 3 , March 2021 , pp. 269 - 272
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S Hosokawa takes responsibility for the integrity of the content of the paper

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