| Title |
Incidence and Risk Factors for Occult Level 3 Lymph Node Metastases in Papillary Thyroid Cancer
|
|---|---|
| Published in |
Annals of Surgical Oncology, May 2016
|
| DOI | 10.1245/s10434-016-5254-8 |
| Pubmed ID | |
| Authors |
Sheila Fraser, Nisar Zaidi, Olov Norlén, Anthony Glover, Schelto Kruijff, Mark Sywak, Leigh Delbridge, Stan B. Sidhu |
| Abstract |
Papillary thyroid cancer (PTC) frequently disseminates into cervical lymph nodes. Lateral node involvement is described in up to 50 % patients undergoing prophylactic lateral neck dissection. This study aimed to assess this finding and identify which factors predict for occult lateral node disease. Patients with fine needle aspiration-confirmed PTC (Bethesda V or VI), without evidence of cervical lymph node metastases, underwent a total thyroidectomy with prophylactic ipsilateral central and level 3 dissection. Level 3 nodes were removed by compartmental dissection or by sampling the sentinel nodes overlying the jugular vein, according to surgeon preference. Data were collected prospectively from January 2011 to August 2014. Statistical analysis was performed by SPSS software. A total of 137 patients underwent total thyroidectomy with prophylactic ipsilateral central and level 3 dissection for PTC. The incidence of occult level 3 disease was 30 % (41/137 patients). A total of 48 % of patients (66/137) harbored occult central neck disease. A total of 80.5 % of patients with pN1b disease had macrometastases (≥2 mm), and 15 % exhibited skip metastases with central compartment sparing. In patients with pN1b disease, a median of 6 level 3 nodes were retrieved, with an average involved nodal ratio of 0.29. Multivariate regression demonstrated risk factors for occult lateral neck metastasis include tumor size (odds ratio 1.1), upper pole tumors (odds ratio 6.6), and vascular invasion (odds ratio 3.2) (p < 0.05). PTC is associated with a significant incidence of occult central and lateral nodal metastases. In patients undergoing prophylactic central neck dissection, inclusion of level 3 dissection should be considered in patients with large upper lobe cancers. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 18 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 18 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 3 | 17% |
| Student > Master | 3 | 17% |
| Researcher | 2 | 11% |
| Professor | 2 | 11% |
| Student > Postgraduate | 2 | 11% |
| Other | 2 | 11% |
| Unknown | 4 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 67% |
| Agricultural and Biological Sciences | 1 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 6% |
| Unknown | 4 | 22% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 June 2016.
All research outputs
#15,377,977
of 22,877,793 outputs
Outputs from Annals of Surgical Oncology
#4,400
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Outputs of similar age
#201,999
of 326,835 outputs
Outputs of similar age from Annals of Surgical Oncology
#85
of 117 outputs
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