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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Lymph node metastasis in suprasternal space in pathological node-positive papillary thyroid carcinoma.

Shi-Tong Yu1, Jun-Na Ge1, Bai-Hui Sun1

  • 1Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.

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|August 10, 2019
PubMed
Summary

Suprasternal space lymph node (SSLN) metastasis is significant in pathological node-positive (pN+) papillary thyroid carcinoma (PTC). Factors like primary tumor site and muscle invasion independently predict SSLN metastasis in PTC patients.

Keywords:
Clinicopathological parametersNeck dissectionPapillary thyroid carcinomaStrap muscleSuprasternal space lymph node

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Area of Science:

  • Oncology
  • Head and Neck Surgery
  • Pathology

Background:

  • Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
  • Pathological node-positive (pN+) status indicates a higher risk of cancer recurrence and metastasis.
  • The role of the suprasternal space lymph node (SSLN) in PTC metastasis remains under investigation.

Purpose of the Study:

  • To determine the clinical significance of SSLN metastasis in pN+ PTC patients.
  • To identify clinicopathological factors associated with SSLN metastasis in PTC.

Main Methods:

  • Retrospective analysis of 140 pN+ PTC patients who underwent neck dissection.
  • Resection and examination of SSLNs to assess metastasis.
  • Statistical analysis including univariate and multivariate assessments of clinicopathological parameters.

Main Results:

  • The SSLN metastasis rate was 20.7% in the study cohort.
  • Univariate analysis revealed associations between SSLN metastasis and primary cancer site (inferior), strap muscle invasion, and specific lymph node levels (III, IV).
  • Multivariate analysis identified primary cancer site (inferior), strap muscle invasion, Level IV metastasis, and inter-sternocleidomastoid/sternohyoid lymph node metastasis as independent risk factors for SSLN metastasis.

Conclusions:

  • SSLN metastasis is a relevant concern in pN+ PTC.
  • Clinicians should consider SSLN status in the management of PTC patients with lymph node involvement.
  • Identifying risk factors for SSLN metastasis can aid in risk stratification and treatment planning.