Ozdemir, Murat1; Makay, Ozer1; Tanal, Mert2; Besler, Evren2; Aygun, Nurcihan2; Icoz, Gokhan1; Akyildiz, Mahir1; Uludag, Mehmet2
1 Department of General Surgery, Ege University Medicine Faculty, Izmir, Turkey
2 Department of General Surgery,Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
Objectives: We aimed to determine factors affecting lateral cervical metastasis in patients who underwent bilateral central node dissection for papillary thyroid cancer (PTC).
Methods: A total of 87 patients undergoing thyroidectomy and bilateral central lymph node dissection between January 2011-2017 were analyzed retrospectively. Patients were assessed regarding demographics, tumour size, multicentricity, bilaterality, adjacent tissue invasion, vascular and capsular invasion, recurrence and disease-free survival rate.
Results: There were 29 male (33%) and 58 female (67%) and the mean age was 45 (16-81) years. Mean follow-up time was 32 (2-72) months. Mean tumour size was 20.9 mm (2-105mm). Seventy four (85%) patients had PTC classical type, 6 (7%) patients had PTC follicular variant and 7 (%8) patients had other subtypes. Fifty four (%66.7) patients had multifocal tumors and in 20 (%48.7) patients tumours were bilateral. Six (% 7) cases had adjacent tissue invasion, while 36 (%42) patients had lymphovascular and 29 (% 34) capsular invasions. Eight patients were found to have recurrence. Forty-two patients underwent therapeutic lateral neck dissection. The mean number of lymph nodes dissected in the lateral neck was 29.6 (9-65), while the number of metastatic nodes was found to be 5.8 (1-16). Bilateral central lymph node metastasis, adjacent tissue invasion and lymphovascular invasion were in association with increased risk for lateral cervical lymph node metastasis (p<0.05). It was not possible to calculate a cut-off value of metastatic central nodes predicting lateral metastasis.
Discussion: Bilateral central lymph node metastasis is in association with lateral lymph node metastasis.
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