Background: Recently, lymph node metastasis (LNM) has been regarded as an important factor influencingloco-regional recurrence and survival rate in papillary thyroid cancer (PTC) patients. Theaims of this study were to investigate the detection rate and metastasis rate of the Delphianlymph node (DLN) and clinical patterns related to regional LNM, and to examine how DLNmetastasis affects PTC treatment. Methods: We reviewed the medical records of 413 patients with pathologically confirmed PTC fromamong 452 patients who underwent thyroid surgery between January 2010 and October 2010in the Department of Endocrine Surgery at Kosin University Gospel Hospital in Busan, SouthKorea. Results: Multivariate analyses revealed a significantly higher proportion of cases with lymphovascularinvasion (56.6% vs. 12.5%, P <0.001), central neck node metastasis (88.6% vs. 34.5%, P<0.001) and lateral neck node metastasis (47.2% vs. 10.2%, P <0.005) among cases withDLN metastasis compared to those without. The negative predictive value (NPV) of DLNmetastasis with regard to the presence of contralateral central LNM for cases with a tumorsize 1 cm or smaller than 1 cm was found to be 93.3% (127/136). Conclusion: When DLN metastasis is not detected in papillary thyroid microcarcinomas (PTMC), thyroidlobectomy on the affected side and ipsilateral central neck lymph node dissection should besufficient. In addition, even in cases where lateral neck LNM is not detected on preoperativeexamination, if DLN metastasis is detected postoperatively, more careful attention should bepaid to the lateral neck nodes during follow-up.
via World Journal of Surgical Oncology
via World Journal of Surgical Oncology
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