Therapeutic Lateral Neck Dissection in Papillary Thyroid Carcinoma
Ali Zedan1, Waleed Ahmed Diab, Hemat A. Mahmoud, Haisam Atta
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Article DOI: 10.21614/sgo-25-5-310
Objective: Papillary thyroid carcinoma (PTC) has a high rate of lateral neck node metastases, lymph node metastasis (LNM) is a vital prognosis factor. The aim of this study was to evaluate morbidity and outcomes of therapeutic lateral neck dissection papillary thyroid cancer (PTC) with lateral lymph node metastasis (LLNM).

Methods: We conducted a retrospective analysis of 78 PTC patients who underwent neck dissections for the management of lateral cervical metastases from January 2010 and January 2020.

Results: 35.9% and 16.7% presented multifocality and bilaterality, respectively. HashimotoĆ¢??s thyroiditis (16.7%), capsular invasion (23.1%), (12.8%) lymphovascular invasion, Extrathyroidal extension (19.2%). PTCs were distributed (38.5%) upper portion, (23.1%) middle portion, (38.5%) lower portion. Skip metastasis (10.3%), pT1 26%, pT2 42.5%, pT24.7% and pT4a 6.8%, tumor size 2.59+-1.16 cm, (48.7%) stage I, (41%) stage II, (10.3%) stage III, metastasis in levels I, II, III, IV and V was 14.1%, 48.7%, 62.8%, 57.7% and 19.2% (15 78), (20.5%) had single-level metastases, and (52.6%) had multiple-level metastases. Ipsilateral metastases in (80.8%) and bilateral metastases in 19.2%. Retrieved LNs was 32 (range, 18 62). Metastatic LNs 4 (range, 1 9) LNR was 0.14 +-0.08, shoulder dysfunction (7.8%), chyle leakage (9%), nodal recurrence (7.4%), 10-year RFS&OS survival rate 92.2%, (97.1%).

Conclusion: Therapeutic lateral neck dissection (LND) is recommended in PTC patients with clinically LLNM, at the time of thyroidectomy. locoregional control is improved with accepted morbidity.

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