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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Experience and analysis of Delphian lymph node metastasis in patients with papillary thyroid carcinoma

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2012
Autoren:
Won Woong Kim, Song I. Yang, Jeong Hoon Kim, Young Sik Choi, Yo-Han Park, Su Kyoung Kwon
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-226) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JHK, the corresponding author of this study, provided the major idea, planed and approved the written work, performed the operations. WWK contributed literature review and writing the manuscript and analyzing clinicopathologic data. SIY contributed literature review and drafted the manuscript. YSC, YHP and SKK gave advices about clinical variables to analyze and edited the discussion. All authors read and approved the manuscript.

Abstract

Background

Recently, lymph node metastasis (LNM) has been regarded as an important factor influencing loco-regional recurrence and survival rate in papillary thyroid cancer (PTC) patients. The aims of this study were to investigate the detection rate and metastasis rate of the Delphian lymph node (DLN) and clinical patterns related to regional LNM, and to examine how DLN metastasis affects PTC treatment.

Methods

We reviewed the medical records of 413 patients with pathologically confirmed PTC from among 452 patients who underwent thyroid surgery between January 2010 and October 2010 in the Department of Endocrine Surgery at Kosin University Gospel Hospital in Busan, South Korea.

Results

Multivariate analyses revealed a significantly higher proportion of cases with lymphovascular invasion (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 with DLN metastasis compared to those without. The negative predictive value (NPV) of DLN metastasis with regard to the presence of contralateral central LNM for cases with a tumor size 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), thyroid lobectomy on the affected side and ipsilateral central neck lymph node dissection should be sufficient. In addition, even in cases where lateral neck LNM is not detected on preoperative examination, if DLN metastasis is detected postoperatively, more careful attention should be paid to the lateral neck nodes during follow-up.
Zusatzmaterial
Authors’ original file for figure 1
12957_2012_1172_MOESM1_ESM.docx
Literatur
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