1. Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
- Author
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Enza Maria Rollo, Federica Saputo, Calogera Amato, Giuseppa Graceffa, Maria Pia Proclamà, Giuseppina Orlando, Alessandro Corigliano, G. Melfa, Gregorio Scerrino, Gianfranco Cocorullo, Calogero Cipolla, S Mazzola, Irene Vitale, Graceffa, Giuseppa, Orlando, Giuseppina, Cocorullo, Gianfranco, Mazzola, Sergio, Vitale, Irene, Proclamà, Maria Pia, Amato, Calogera, Saputo, Federica, Rollo, Enza Maria, Corigliano, Alessandro, Melfa, Giuseppina, Cipolla, Calogero, and Scerrino, Gregorio
- Subjects
medicine.medical_specialty ,skip metastasis ,endocrine system diseases ,medicine.medical_treatment ,030230 surgery ,Article ,03 medical and health sciences ,0302 clinical medicine ,central compartment ,medicine ,lateralcervical lymph nodes ,Lymph node ,Univariate analysis ,business.industry ,EU-TIRADS ,Bethesda ,Cancer ,Neck dissection ,General Medicine ,medicine.disease ,Central lymph ,Dissection ,medicine.anatomical_structure ,lateral neck dissection ,030220 oncology & carcinogenesis ,central neck dissection ,papillary thyroid carcinoma ,Medicine ,Radiology ,Lymph ,Thyroid function ,business - Abstract
Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes <, 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).
- Published
- 2021