[Clinical evaluation of management of superior mediastinal metastasis from thyroid carcinoma with systemic superior mediastinal dissection via sternotomy approach: 12 cases report].
OBJECTIVE
Few research of surgery for superior mediastinal metastasis from thyroid carcinoma has been reported. Previous surgical approach from neck had the problems of easy damage of nerve and vessels and the difficulty of clearance of lymph nodes. This study was designed to assess the value of systemic superior mediastinal lymph node dissection via sternotomy for superior mediastinal metastasis from differentiated thyroid carcinoma.


METHODS
A retrospective study was performed to analyze the clinical pathologic data as well as the outcome of 12 cases of differentiated thyroid carcinoma treated with systemic superior mediastinal lymph node dissection via sternotomy approach from April 1995 to April 2002, including 7 cases of papillary adenocarcinoma and 5 cases of medullary carcinoma.


RESULTS
Pathologically, the incidence rates of metastasis to anteriotracheal lymph node, paratracheal lymph node, anterior superior vena cava, and anterior innominate artery lymph nodes were 55.6% (25/45), 57.1% (36/63), 42.1% (8/19) and 30% (3/10), respectively. All cases are still alive in one to seven years follow-up period. The median follow-up was 32 months. Upper mediastinal lymph nodes were recurrent in one case; distant metastasis occurred in two cases.


CONCLUSIONS
Systemic superior mediastinal lymph node dissection via sternotomy approach can be employed in treating superior mediastinal lymph node metastasis from differentiated thyroid carcinoma due to its safety and relatively satisfactory outcome.
Zhang
Quan
Q
Department of Head and Neck Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P.R.China. yuqianzhang@tom.com
Guo
Zhu-Ming
ZM
Fu
Jian-Hua
JH
Zeng
Zong-Yuan
ZY
Chen
Fu-Jin
FJ
Wei
Mao-Wen
MW
Wu
Guo-Hao
GH
Yang
An-Kui
AK
D000231:Adenocarcinoma, Papillary / Q000556:secondary / Q000601:surgery*; D000328:Adult; D018276:Carcinoma, Medullary / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome