EP138 – Factors affecting lateral neck metastasis in patients undergoing bilateral central lymph node dissection due to papillary thyroid carcinoma: a retrospective multicenter study

      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. References:
    1. Keum HS, Ji YB, Kim JM, Jeong JH, Choi WH, Ahn YH, Tae K. Optimal surgical extent of lateral and central neck dissection for papillary thyroid carcinoma located in one lobe with clinical lateral lymph node metastasis.World J Surg Oncol. 2012 Oct 25;10:221.
    2. Ducoudray R, Trésallet C, Godiris-Petit G, Tissier F, Leenhardt L, Menegaux F.Prophylactic lymph node dissection in papillary thyroid carcinoma: is there a place for lateral neck dissection? World J Surg. 2013 Jul;37(7):1584-91.
    3. Roh JL, Kim JM, Park CI.Lateral cervical lymph node metastases from papillary thyroid carcinoma: pattern of nodal metastases and optimal strategy for neck dissection.Ann Surg Oncol. 2008 Apr;15(4):1177-82.


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