Level VI and II-V cervical lymph node metastasis in differentiated thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the characters of the cervical lymph node metastasis in differentiated thyroid carcinoma, and to provide evidence for proper surgery of differentiated thyroid carcinoma.</p><p><b>METHODS</b>From 1984 to 2000, 99 cases with differentiated thyroid carcinoma were performed thyroidectomy and neck dissection. The patients were followed up. A retrospective analysis was performed. Results In 99 cases with differentiated thyroid carcinoma, there were 61 papillary carcinoma, 13 papillary and follicular mixed carcinoma, 25 follicular carcinoma. According to 2002 UICC TNM classification, 60 cases were staged I, 1 case staged II, 5 cases staged III, 33 cases staged IV. Lobectomy and isthmectomy was performed in 80 cases, lobectomy was resected and opposite subtotal lobectomy in 15 cases, total thyroidectomy in 4 cases. One hundred and four neck dissection were performed in 99 cases (5 cases were bilateral neck dissection ). Among them, 66 (68 sides) were radical neck dissection, 33 (36 sides) were modified neck dissection. Pathological results showed that lymph nodes were positive in 86 sides of 83 cases. The rate of cervical lymph node metastasis was 83.8% (83/99). The positive rates of lymph node were 37.5% (39/104) in level VI and 76.9% (80/104) in II-V, which was statistically different (chi2 = 33.01, P < 0.01). The cervical lymph node metastasis in lateral area (level II-V) and that in VI had not relationship (chi2 = 2.08, P > 0.05). Ten and 15 year survival rates of all 99 cases were 88.3% and 84.5% respectively.</p><p><b>CONCLUSIONS</b>The occurrence of lymph node metastasis in level VI and level II was different and no relationship .One can not judge whether lateral neck metastasis by the lymph node statue in level VI only . Although they all had good prognosis, patients with positive nodes in level VI were not worse than that in lateral neck (II-V).</p>