title: Right paraesophageal lymph node dissection in papillary thyroid carcinoma.
abstract: BACKGROUND
  This study was designed to identify the patients with papillary thyroid carcinoma (PTC) who would benefit from RPELN dissection.
  
  
  BACKGROUND
  The value of the right paraesophageal lymph nodes (RPELNs), which are located posterior to the right recurrent laryngeal nerve, may be underestimated. Although the RPELNs are common sites of nodal recurrence, few related studies have been reported.
  
  
  METHODS
  We retrospectively reviewed the medical records of 369 patients (286 female, 83 male) who underwent total thyroidectomy (327 patients) or right lobectomy (42 patients) with therapeutic or prophylactic central lymph node dissection for primary PTC between August 2008 and January 2010 at the Department of Surgery, Samsung Medical Center.
  
  
  RESULTS
  Central lymph node (CLN) metastases were present in 51.2% (189 of 369) of the patients, and RPELN metastases were present in 12.2% (45 of 369) of the patients. The rate of RPELN metastasis was 19.6% (37 of 189) in patients with CLN metastases, but only 4.4% (8 of 180) in patients with no CLN metastases (P < .001). A univariate analysis revealed that RPELN metastasis was significantly correlated with the size of the tumor, the perithyroidal extent (capsular invasion), CLN metastasis, and lateral lymph node metastases. There were no significant differences in terms of gender, mean age, or number of tumors between groups. A multivariate analysis revealed that tumor size (>1 cm) and number of CLN metastases (≥ 3) were significantly correlated with RPELN metastasis.
  
  
  CONCLUSIONS
  RPELN dissection should be considered in patients with right thyroid cancer, tumors larger than 1 cm, or multiple CLN metastases.
authors.affiliation: Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea. 20110366@kuh.ac.kr
authors.forename: Soo Youn
authors.initials: SY
authors.lastname: Bae
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Yang
authors.forename: Min-Young
authors.initials: MY
authors.lastname: Choi
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Choe
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Jee Soo
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D004947:Esophagus; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy