title: Incidence and clinical characteristics of prelaryngeal lymph node metastasis in papillary thyroid cancer.
abstract: There is little data that determine the clinical characteristics of prelaryngeal lymph nodes (PLN) metastasis in patients with papillary thyroid cancer (PTC). The aims of this prospective study were to evaluate the incidence and the clinical characteristics of metastasis to the PLN for PTC patients who underwent total thyroidectomy and prophylactic central neck dissection. Sixty-seven patients who underwent total thyroidectomy and prophylactic bilateral central lymph node neck dissection for PTC were enrolled. Central neck compartment was further divided into prelaryngeal, ipsilateral/contralateral paratracheal, and pretracheal regions. Clinicopathologic factors including age, sex, tumor size and location, extrathyroidal extension, and central and lateral nodal metastasis were evaluated. Of the 67 patients who underwent PLN dissection, 13 (19.4 %) had evidence of PLN metastasis. Tumor size was significantly larger in patients with PLN involvement (2.28 versus 1.12 cm; p = 0.020). Additionally, primary tumors larger than 1 cm, extrathyroidal extension, and isthmus involvement were more prevalent in PLN-positive patients. Patients with positive PLNs were also more frequently found to have lateral lymph node metastasis (23.1 vs. 1.9 %; p = 0.021), pretracheal lymph node metastasis (76.9 vs. 27.8 %; p = 0.003), and bilateral central lymph node metastasis (38.5 vs. 11.1 %; p = 0.031) than PTC patients without PLN involvement. The incidence of PLN metastasis in PTC patients who underwent prophylactic central lymph node neck dissection was 19.4 %. PLN metastasis was associated with tumor size, extrathyroidal extension, isthmus involvement, and other compartment lymph node metastasis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea.
authors.forename: Young Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Seung Youp
authors.initials: SY
authors.lastname: Shin
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Kwon
authors.forename: Young Gyu
authors.initials: YG
authors.lastname: Eun
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology; D002291:Carcinoma, Papillary / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000473:pathology; D013965:Thyroidectomy / Q000379:methods*
references.citation: Head Neck. 1996 Mar-Apr;18(2):127-32
references.pmid: 8647677
references.citation: Laryngoscope. 1997 Mar;107(3):332-4
references.pmid: 9121308
references.citation: Otolaryngol Clin North Am. 2008 Aug;41(4):673-95, v
references.pmid: 18570953
references.citation: Acta Otolaryngol. 2002 Jun;122(4):456-7
references.pmid: 12126008
references.citation: Anticancer Res. 2003 May-Jun;23(3C):2961-3
references.pmid: 12926144
references.citation: Ann Surg Oncol. 2006 Nov;13(11):1524-8
references.pmid: 17006742
references.citation: Tumori. 1985 Aug 31;71(4):361-5
references.pmid: 4049538
references.citation: Laryngoscope. 1987 Sep;97(9):1033-7
references.pmid: 3626727
references.citation: Ann Surg. 2011 May;253(5):988-91
references.pmid: 21372688
references.citation: Auris Nasus Larynx. 2001 Aug;28(3):233-40
references.pmid: 11489367
references.citation: Ann Surg. 2008 Mar;247(3):477-82
references.pmid: 18376193
references.citation: Cancer. 2006 Feb 1;106(3):524-31
references.pmid: 16369995
references.citation: World J Surg Oncol. 2012 Oct 30;10:226
references.pmid: 23110552