Whether VI region lymph nodes belong to primary site of the thyroid carcinoma or lateral cervical lymph node metastases / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the evaluation of elective neck dissection (END) for the cN(0) patients with papillary thyroid carcinoma (PTC).</p><p><b>METHODS</b>By analyzing the recurrent and metastatic region (thyroid, group VI lymph nodes, lateral neck region, beyond neck) of 139 PTC patients treated secondly in our hospital, group VI lymph nodal metastasis is divided into recurrence of primary site and distinguished from lateral neck lymph nodes. The clinical value of END for cN(0) PTC patients is also retrospectively analyzed.</p><p><b>RESULTS</b>Thyroidal recurrence accounts for 83% (73/88). Level VI metastasis accounts for 76% (67/88), 17 patients have received END and account for 65% (17/26). Metastasis to lateral neck lymph nodes account for 17% (17/98), among these patients, 5 patients have received END and account for 19% (5/26).</p><p><b>CONCLUSIONS</b>For the patients with cN(0) PTC, ipsilateral thyroid lobectomy plus level VI dissection is recommended and lateral END (level II-V) is not supported. For the patients with cN(0) but UB N(+) and/or CT N(+), lateral END (level II-V) is recommended. The necessity of CT examination in the diagnosis and treatment of thyroid cancer should be emphasized.</p>