The Significance of Internal Jugular Node Sampling in Well-Differentiated Thyroid Cancer

ABSTRACT

To evaluate the role of internal jugular node sampling in the operation for well-differentiated thyroid cancer, 86 patients received the operation for well-differentiated thyroid cancer from one surgeon. Ipsilateral internal jugular node (level 3 and 4) sampling was done after total thyroidectomy and central compartment neck dissection (CCND) in clinically node negative well-differentiated thyroid cancer. A modified radical neck dissection, type IIIB, was done in the patients proved as metastasis on the frozen biopsy of the sampling. The overall metastatic rate of the internal jugular lymph node was 72.5% (50 of 69), and the metastatic rate of the internal jugular node sampling in clinically negative lymph node metastasis was 57.4% (31 of 54). The most frequent metastatic lymph-node group was level 6. The metastasis of the internal jugular lymph node was more frequent in large tumor and extracapsular involvement, but there was no statistical significance. The rates of internal jugular node metastasis were 50.0% in follicular, medullary, and H rthle cell carcinomas. In conclusion, sampling of the internal jugular node was an important guideline in deciding a modified radical neck dissection in patients with well-differentiated thyroid cancer.