[Clinical evaluation of extended neck differentiated thyroid carcinoma].
In some patients with advanced differentiated thyroid carcinoma, an upper mediastinal dissection is recommended. Both 17 primary and 6 non-primary patients who had undergone an upper mediastinal dissection in Shinshu University Hospital, from 1984 to 1987, were surveyed. We also studied 198 patients who had been performed a modified radical neck dissection from 1984 to 1986. In the 17 primary cases, 6 (35%) had positive nodes in the upper mediastinum (M group), and 11 (65%) negative (NM group). And we analysed these two groups. In addition, 5 non-primary cases and 198 patients were analyzed in terms of the nodal metastatic status of the tumor-free side. From these results, we conclude the indication of mediastinal dissection for thyroid carcinoma as follows: (1) positive lymph node is suspected in the upper mediastinum by the study of CT or 201thallium scintigram. (2) nodal metastases are suspected in the deep cervical location of the tumor-free side. (3) a male patient whose age is younger than 50, and tumor is located in the left lobe and its size is larger than 3.0 cm.
Asanuma
K
K
Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Sugenoya
A
A
Kobayashi
S
S
Kasuga
Y
Y
Masuda
H
H
Senga
O
O
Iida
F
F
D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D037981:Neck Dissection / Q000379:methods*; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*