Clinical Research Papers:
Clinical value and indication for the dissection of lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma
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Ding-Cun Luo1, Xiao-Cheng Xu2, Jin-Wang Ding1, Yu Zhang1, You Peng1, Gang Pan1 and Wo Zhang1
1Department of Surgical Oncology, Hangzhou First People’s Hospital, Nanjing Medical University, Zhejiang, China
2Department of Surgery of Thyroid and Breast, Wujiang District of Suzhou First People’s Hospital, Jiangsu, China
Ding-Cun Luo, email: [email protected]
Keywords: lymph node posterior to right recurrent laryngeal nerve, neck dissection, PTC, risk factors, metastasis
Received: January 12, 2017 Accepted: August 06, 2017 Published: August 16, 2017
Lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) are common sites of nodal recurrence after the resection of papillary thyroid carcinoma (PTC). However, the indication for LN-prRLN dissection remains debatable. We therefore studied the relationships between LN-prRLN metastasis and the clinicopathological characteristics in 306 patients with right or bilateral PTC who underwent LN-prRLN dissection. We found that LN-prRLN metastasis occurred in 16.67% of PTC and was associated with a number of the clinicopathological features. The receiver-operator characteristic (ROC) analysis showed that the areas under the ROC curves for the prediction of LN-prRLN metastasis by the risk factors age < 35.5 years, right tumor size > 0.85 cm, lymph node (right cervical central VI-1) number > 1.5, metastatic lymph node (right cervical central VI-1) size > 0.45 cm, and lymph node number in the right cervical lateral compartment > 0.5 were 0.601, 0.815, 0.813, 0.725, and 0.743, respectively.
In conclusion, the risk factors for LN-prRLN metastasis in patients suffering right thyroid lobe or bilateral PTC include age ≤ 35.5 years, right tumor size ≥ 0.85 cm, capsular invasion, metastatic lymph node (right cervical central VI-1) number ≥ 2, metastatic lymph node (right cervical central VI-1) size ≥ 0.45 cm, and metastatic lymph node number in the right cervical lateral compartment ≥ 1. In patients whose risk factors can be identified pre-operatively or intraoperatively, the dissection of LN-pr-RLN should be considered during right cervical central compartment dissection.
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