[Significance of modified radical neck dissection in papillary thyroid carcinoma].
OBJECTIVE
To investigate the recurrence of the neck and survival incidence of clinically possible positive lateral cervical nodes in patients with well-differentiated papillary thyroid cancer and the essentiality of the perforation of modified radical neck dissection.


METHODS
Retrospective datum of 267 cases of papillary thyroid carcinoma were collected and analyzed. They were divided into two groups with time; selective neck dissection with VI area was performed in 151 cases of group A and selective neck dissection was performed without VI area in 116 cased of group B. They were received the same treatment in the thyroid--total thyroidectomy on initial part and subtotal thyroidectomy on the other, and total thyroidectomy on both parts if both were invited. Incidence of positive lateral cervical nodes of VI area in group A and the recurrence in the neck and survival incidence in groups B were analyzed.


RESULTS
Fifty nine patients in group A were treated with the modified radical neck dissection, and 22 patients of them were found metastasis in lateral cervical nodes with VI area. The other 92 patients were treated with neck dissection of II, III, IV, VI area, and 31 patients weren't metastasis, 33 patients were metastasis in both VI area and the others (35.8%), 17 patients were metastasis only in VI area (18.4%), 11 patients weren't metastasis only in VI area (11.9%). Thus, the incident of metastasis in VI area was 47.70% in group A (72/151). 47 patients in group B had metastasis in lateral cervical nodes though without performing VI area neck dissection (40.5%), and the survival rate of 5 years was 99.3%. The recurrence rate in the neck of group two was 6.0% (7/116). The metastasis rate of neck lymph node was higher in group A (54.9%) than group B (40.5%).


CONCLUSIONS
Pretracheal and peripheral recurrent nerve lymph node are very susceptible to the metastasis of well-differentiated papillary thyroid cancer. The neck dissection of VI area could be performed as routine.
Hu
An
A
Department of Otolaryngology-Head and Neck Surgery, Institute of Otolaryngology, Renji Hospital, Medical College of Shanghai Jiaotong University, Shanghai, 200001, China.
Jin
Xiaojie
X
Qian
Min fei
Mf
Zhou
Ming
M
Li
Jiping
J
Wang
Jiadong
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D002291:Carcinoma, Papillary; D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D055815:Young Adult