The online version of this article (doi:10.1186/1477-7819-10-164) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
WCP: participated in the conception and design of the study and carried out the surgery. YSK: participated in data analysis and interpretation of data drafted the manuscript. All authors read and approved the final manuscript.
Central and lateral lymph node metastases are quite common in patients with papillary thyroid carcinoma, and the predictors for those metastases have been well studied. Right upper paraesophageal lymph node metastasis has rarely been studied. The aim of this study was to identify the clinicopathological characteristics that may be risk factors for right upper paraesophageal lymph node metastasis in patients with papillary thyroid carcinoma.
This was a prospective observational study of 243 patients with papillary thyroid carcinoma (PTC) who underwent total thyroidectomy and comprehensive central lymph node dissection with or without lateral lymph node dissection between April 2008 and January 2010. The clinicopathologic findings from these patients were investigated and the patterns of lymph node metastasis were analyzed in the patients who had right upper paraesophageal lymph node disease.
Of the 243 patients undergoing lymph node dissection, 14 had right upper paraesophageal lymph node metastases. Two of these patients had right upper paraesophageal lymph node metastasis only, without central compartment metastasis. Univariate analysis of clinicopathologic findings showed that right upper paraesophageal lymph node metastasis had significant association with larger primary tumors, multifocal tumors, extrathyroid extension, and lymphatic invasion (p < 0.05 for each factor).
Although there were no independent predictors of right upper paraesophageal lymph node metastasis, it can be the only site of metastasis without other compartmental metastasis. Therefore, during surgery for patients with central or lateral lymph node metastases from PTC, it may be helpful to examine the right upper paraesophageal lymph nodes.
Authors’ original file for figure 112957_2012_1082_MOESM1_ESM.jpeg
Grebe SK, Hay ID: Thyroid cancer nodal metastases: biologic significance and therapeutic considerations. Surg Oncol Clin N Am. 1996, 5: 43-63. PubMed
White ML, Doherty GM: Level VI lymph node dissection for papillary thyroid cancer. Minerva Chir. 2007, 62: 383-393. PubMed
Hay ID, Bergstralh EJ, Goellner JR, Ebersold JR, Grant CS: Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery. 1993, 114: 1050-1057. discussion 1057–1058 PubMed
Kouvaraki MA, Shapiro SE, Fornage BD, Edeiken-Monro BS, Sherman SI, Vassilopoulou-Sellin R, Lee JE, Evans DB: Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003, 134: 946-954. 10.1016/S0039-6060(03)00424-0. discussion 954–945 CrossRefPubMed
Leboulleux S, Rubino C, Baudin E, Caillou B, Hartl DM, Bidart JM, Travagli JP, Schlumberger M: Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab. 2005, 90: 5723-5729. 10.1210/jc.2005-0285. CrossRefPubMed
- Clinical predictors of right upper paraesophageal lymph node metastasis from papillary thyroid carcinoma
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II