Predictors of Lateral Cervical Lymph Node Metastases in Differentiated Thyroid Cancer
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- Category: Vol. 84, June 2016
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Predictors of Lateral Cervical Lymph Node Metastases in Differentiated Thyroid Cancer, MAHMOUD H. EL-SHOIEBY, AHMED A.S. SALEM and GAMAL EMIRA
Abstract
Background: Some studies have shown that the addition of a lateral neck nodal dissection to central neck compartment surgery doubles the risk of transient postoperative hyperpar-athyroidism. The aim of this study was to evaluate predictors of patients with differentiated thyroid cancer who have lateral cervical lymph node metastasis and need lateral neck nodal dissection.
Patients and Methods: This is a retrospective study which will include all patients who had undergone thyroidectomy for differentiated thyroid cancer at South Egypt Cancer institute between Jan. 2010 to Dec. 2014. The following factors will be analyzed to detect the most important predictors of lateral cervical lymph node metastasis; primary tumor size, age, sex, thyroid capsular invasion, multifocality of primary disease, histological type and clinical and radiological evidence of lymph node involvement.
Results: The study included 69 patients with well differ-entiated thyroid cancer who were managed at Surgical Oncol-ogy Department, South Egypt institute from Jan. 2010-Dec. 2014. 16 patients were males (23.19%) and 53 females (76.81%) A mean (SD) age of 42.71 years. A median of 41 years (range: 10-78). 44 patients (63.77%) with papillary thyroid cancer, 15 patients (21.74%) with follicular variant of papillary thyroid cancer, and 10 patients (14.49%) with follicular thyroid cancer. Capsular invasion detected in 29 patient (45.31%) while no invasion in 35 patients (54.69%). Clinically 41 patients (59.42%) don't have LN. involvement and 28 patients (40.58%) show L.N. involvement, by neck U/S43 patients (62.32%) don't have LN. involvement and 26 patients (37.68 %) show L.N. involvement.
Conclusion: Positive clinical examination and U/S neck examinationare the most dependent and reliable factors to detect lateral cervical lymph node involvement, which indicate lateral cervical lymph node dissection.