Lymph node dissection in the lateral neck for completion in central node-positive papillary thyroid cancer.

Area of Science:

• Oncology
• Surgical Pathology
• Head and Neck Surgery

Background:

• Quantitative relationships between central and lateral neck lymph node metastases in papillary thyroid cancer may have clinical utility.
• Understanding these associations can inform surgical management strategies.

Purpose of the Study:

• To comparatively analyze central and lateral neck lymph node metastases in papillary thyroid cancer.
• To investigate the correlation between the extent of central lymph node involvement and the presence/extent of lateral neck metastases.

Main Methods:

• Comparative analysis of lymph node metastases in 88 patients with untreated papillary thyroid cancer.
• Compartment-oriented lymph node dissection of the central and ipsilateral lateral neck, with contralateral dissection in 32 patients.

Main Results:

• A significant increase in ipsilateral and contralateral lateral neck lymph node metastases was observed with more than 5 positive central lymph nodes (P < .001 and P = .009, respectively).
• Contralateral lateral neck metastases consistently coexisted with central and ipsilateral lateral neck metastases.
• Ipsilateral neck demonstrated a higher incidence and greater number of lateral lymph node metastases compared to the contralateral neck.

Conclusions:

• Histopathologic associations between central and lateral neck lymph node metastases in papillary thyroid cancer are significant.
• These findings support evidence-based decisions for lateral neck lymph node dissection in node-positive papillary thyroid cancer patients.