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Therapeutic lateral neck dissection in well‐differentiated thyroid cancer: Analysis on factors predicting distribution of positive nodes and prognosis
Author(s) -
Lombardi Davide,
Paderno Alberto,
Giordano Davide,
Barbieri Diego,
Taboni Stefano,
Piazza Cesare,
Cappelli Carlo,
Bertagna Francesco,
Barbieri Verter,
Piana Simonetta,
Bellafiore Salvatore,
Spriano Giuseppe,
Mercante Giuseppe,
Nicolai Piero
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24936
Subject(s) - medicine , neck dissection , thyroid carcinoma , thyroid cancer , dissection (medical) , thyroid , metastasis , carcinoma , retrospective cohort study , cancer , radiology , surgery
Background Neck dissection is considered the treatment of choice in patients with lateral neck metastases from well‐differentiated thyroid cancer. Methods A multicenter, retrospective review of patients who underwent therapeutic lateral neck dissection for well‐differentiated thyroid carcinoma was carried out. Results The study included a total of 405 lateral neck dissections performed in 352 patients; 197 women (56%) and 155 men (44%). When considering ipsilateral neck metastases, levels IIa, IIb, III, IV, Va, Vb, and V (not otherwise specified) were involved in 42%, 6%, 73%, 67%, 11%, 31%, and 35% of cases, respectively. Five‐year and 10‐year overall survival (OS) were 93% and 81%, respectively. Age >55 years, pathologic T (pT)4 category, tumor diameter >4 cm, aggressive variants of well‐differentiated thyroid carcinoma, endovascular invasion, and number of positive nodes >5 turned out to be the most important prognostic factors. Conclusion Neck dissection is a valid treatment option in the presence of neck metastasis from well‐differentiated thyroid carcinoma. Levels IIa, III, IV, and Vb should always be removed.