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Right paraesophageal lymph node dissection in papillary thyroid carcinoma.
Soo Youn Bae1, Jung-Hyun Yang, Min-Young Choi
1Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea. 20110366@kuh.ac.kr
Annals of Surgical Oncology
|November 19, 2011
Summary
Right paraesophageal lymph node (RPELN) dissection is recommended for papillary thyroid carcinoma (PTC) patients with tumors larger than 1 cm or multiple central lymph node metastases. This helps identify patients who may benefit from this procedure.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Right paraesophageal lymph nodes (RPELNs) are potential sites for papillary thyroid carcinoma (PTC) recurrence, yet their clinical significance is often underestimated.
- Few studies have investigated the role of RPELNs in PTC, highlighting a gap in understanding their impact on patient outcomes.
Purpose of the Study:
- To identify patients with papillary thyroid carcinoma (PTC) who would benefit from right paraesophageal lymph node (RPELN) dissection.
- To evaluate the prevalence and predictors of RPELN metastasis in PTC patients.
Main Methods:
- Retrospective review of 369 patients with primary PTC who underwent thyroidectomy and central lymph node dissection between August 2008 and January 2010.
- Analysis of clinicopathological data, including tumor size, extrathyroidal extension, and lymph node metastasis status.
Main Results:
- Central lymph node (CLN) metastases were found in 51.2% of patients, and RPELN metastases in 12.2%.
- RPELN metastasis was significantly higher in patients with CLN metastases (19.6%) compared to those without (4.4%).
- Multivariate analysis identified tumor size (>1 cm) and number of CLN metastases (≥3) as significant predictors of RPELN metastasis.
Conclusions:
- Right paraesophageal lymph node (RPELN) dissection should be considered for patients with right-sided thyroid cancer, tumors larger than 1 cm, or multiple central lymph node metastases.
- These findings suggest that RPELN dissection can be a valuable component of surgical management for select PTC patients.
