title: Management of lateral cervical metastases in papillary thyroid cancer: patterns of lymph node distribution.
abstract: In this article we discuss the management of lateral cervical lymph node metastases in papillary thyroid cancer (PTC). We conducted a retrospective analysis of cases of PTC at our tertiary academic medical center involving 32 patients who underwent 39 neck dissections for the management of lateral cervical metastases from 2000 to 2007. Of these patients, 18 underwent primary neck dissections at the time of thyroidectomy after fine-needle aspiration biopsy confirmed the PTC. Secondary neck dissections for delayed metastases were performed in 14 patients who had previously undergone thyroidectomy for confirmed PTC. All 32 patients had positive nodes in at least one level. Our results highlight the high incidence of multilevel cervical metastasis associated with PTC and suggest the importance of including level II-B (submuscular recess) when performing a neck dissection; the upper posterior triangle (level V-A) is less likely to harbor occult tumor. Lateral neck metastasis from PTC is common and predictable; locoregional control is improved with a formal, comprehensive neck dissection at the time of thyroidectomy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA.
authors.forename: J Michael
authors.initials: JM
authors.lastname: King
authors.forename: Christian
authors.initials: C
authors.lastname: Corbitt
authors.forename: Frank R
authors.initials: FR
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult