title: Pattern of nodal involvement in papillary thyroid cancer: a challenge of quantitative analysis.
abstract: BACKGROUND
  Backgrounds of this study were to examine and analyse the relationship among the number of lymph nodes with metastases harvested in central and lateral compartments, the characteristics of tumours and patients, and the recurrences rate.
  
  
  METHODS
  A retrospective review of 118 patients treated for a papillary thyroid cancer and underwent to neck dissection, including in all cases both central and lateral compartment, was realised. A quantitative analysis, on this homogeneous cohort of patients, was performed to hypothesize the minimum number of cervical lymph nodes to be necessarily excised in order to obtain an adequate management of these patients.
  
  
  RESULTS
  The mean follow-up time was 75.9 months. Five-year overall survival was 96.6%. The correlation among the metastatic lymph node number of the ipsilateral central compartment, isolated or pooled with those of the ipsilateral lateral compartment, age of patient and tumour size revealed a statistical significance (P=0.01); both parameters, tumour size and age, may be considered as dependent predictor variables.
  
  
  CONCLUSIONS
  We suppose, notwithstanding the limited number of patients, that the number of lymph nodes harvested to achieve an optimal cervical dissection may be superior to 8 and 11 in central and lateral compartments, and 6 and 10 in contralateral ones, respectively. Moreover we recommend the bilateral dissection of central nodes compartment in presence of tumour localised in the isthmus.
authors.affiliation: Department of Human Pathology, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Fama
authors.affiliation: Department of Human Pathology, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cicciù
authors.affiliation: Department of Clinical & Experimental Medicine, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Giuseppe Lo
authors.initials: GL
authors.lastname: Giudice
authors.affiliation: Department of Biomedical Sciences, Morphological and Functional Images University of Messina Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sindoni
authors.affiliation: Department of Human Pathology, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Jessica
authors.initials: J
authors.lastname: Palella
authors.affiliation: Department of General, Endocrine and Thoracic Surgery, Regional Hospital of Orleans, 14, Avenue de l'Hôpital Orléans 45067, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Piquard
authors.affiliation: Department of General, Endocrine and Thoracic Surgery, Regional Hospital of Orleans, 14, Avenue de l'Hôpital Orléans 45067, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Saint-Marc
authors.affiliation: Department of Clinical & Experimental Medicine, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy ; Interdept Program of Molecular & Clinical Endocrinology and Women's Endocrine Health, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Benvenga
authors.affiliation: Department of Clinical & Experimental Medicine, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Bramanti
authors.affiliation: Department of Clinical & Experimental Medicine, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cervino
authors.affiliation: Department of Human Pathology, University Hospital of Messina Via Consolare Valeria, 1, Messina 98125, Italy.
authors.forename: Maria Gioffre
authors.initials: MG
authors.lastname: Florio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D037981:Neck Dissection; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*; D055815:Young Adult
keywords: Papillary thyroid cancer; cervical dissection; lymph node metastases; quantitative analysis