title: [Clinical analysis of level V occult metastasis of papillary thyroid carcinoma].
abstract: OBJECTIVE
  To analyze the occult level V lymph node (LN) metastases in papillary thyroid carcinoma (PTC) with clinical factors.
  
  
  METHODS
  The clinical data of 203 PTC patients with clinical positive neck lymph nodes in level II, III and IV based on preoperative ultrasonography, who underwent therapeutic lateral neck dissection (level II-V) between January 2001 and June 2009 were retrospectively reviewed. There were 60 male and 143 female patients in the study. The median age at diagnosis was 42 years (ranging from 16 to 76 years). The 203 patients had undergone ipsilateral thyroidectomy and simultaneously neck dissections (II-VI). All patients had no suspicion of clinical positive neck nodes in level V. Univariate and Multivariate analysis were performed using the Pearson chi-square test and a binary logistic regression test, respectively.
  
  
  RESULTS
  The rate of metastatic at levels II, III and IV was 47.3%(96/203), 79.8%(162/203), 81.3% (165/203), respectively. The rate of occult metastatic at level V were observed in 14.3%(29/203). In univariate analysis, LN metastasis in level V was statistically significantly more frequent in patients with positive level IV LNs (χ(2) = 5.651, P = 0.017) and positive LNs throughout the lateral neck (level III+IV) (χ(2) = 10.936, P = 0.001). Multivariate analysis showed that positive LN involvement in all lateral neck (level III+IV) is an independent predictive factor of level V LN metastasis (P = 0.046, OR = 4.550).
  
  
  CONCLUSIONS
  In PTC patients without suspicious LNs in neck level IV by preoperative ultrasound, prophylactic level V LN dissection may be omitted.
authors: The First Department of Head and Neck, Cancer Hospital, Tianjin Medical University, Key Laboratory of Cancer Prevention and Therapy, China. lun_zhang_jing@yahoo.com.cn
authors: Liu-Yang
authors: LY
authors: Zhang
authors: Xuan
authors: X
authors: Zhou
authors: Yan-Sheng
authors: YS
authors: Wu
authors: Lun
authors: L
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary; 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; D013965:Thyroidectomy; D055815:Young Adult