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Value of the Cervical Compartments in the Surgical Treatment of Papillary Thyroid Carcinoma

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An Erratum to this article was published on 16 December 2005

Abstract

In the treatment of papillary thyroid carcinoma (PTC), supplementary lymph node dissection (LND) is not well standardized. The purpose of this study was to evaluate the significance of the cervical compartments in the lymphatic spread of PTC and the impact of modified radical neck dissection (MRND) as an additional surgical procedure to thyroid resection. From 1999 to 2002, LND of the central compartment (compartment A) was performed in 39 patients. Among this group, additional MRND of the ipsilateral compartment (compartment B) and the contralateral compartment (compartment C) was performed in 29 and 15 patients respectively, who met the selection criteria. The mean number of nodes resected was 11 (5–22) in compartment A, 23 (8–37) in compartment B, and 22 (10–31) in compartment C. Histopathologic findings revealed node invasion of compartment A in 25 patients (64.1%), of A and B in 20 patients (51,2%) and of A, B, and C in 13 patients (33.3%). From the 25 patients with metastases in compartment A, 80% (20 patients) already had metastases in compartment B and 52% (13 patients) had metastases in all three compartments. All patients free of metastasis (M0) in compartment A were also metastasis free in both lateral compartments. Postoperative whole-body scanning I131 in M0 patients showed no uptake at all. Mapping of the cervical anatomy in compartments seems to be a useful taxonomy for clarifying the lymphatic spread of PTC. Patients having PTC without metastasis in compartment A are almost certainly disease free at the time of operation. Lymph node metastasis in the central compartment appears to be a valuable indicator of lymphatic invasion of the lateral compartment and a strong indication for performance of a unilateral or bilateral MRND to complete the surgical removal of tumor.

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References

  1. EL Mazzaferri RL Young (1981) ArticleTitlePapillary thyroid carcinoma: a 10 years follow-up report of the impact of therapy in 576 patients Am. J. Med. 70 511–518 Occurrence Handle10.1016/0002-9343(81)90573-8 Occurrence Handle1:STN:280:Bi6C2MjivFw%3D Occurrence Handle7211893

    Article  CAS  PubMed  Google Scholar 

  2. CS Grant ID Hay IR Gough et al. (1988) ArticleTitleLocal recurrence in papillary thyroid carcinoma: is extent of surgical resection important? Surgery 104 954–962 Occurrence Handle1:STN:280:BiaD2Mfot1U%3D Occurrence Handle3194847

    CAS  PubMed  Google Scholar 

  3. EP Breaux OM Guillamondegui (1980) ArticleTitleTreatment of locally invasive carcinoma of the thyroid: how radical? Am. J. Surg. 140 514–517 Occurrence Handle10.1016/0002-9610(80)90202-0 Occurrence Handle7425234

    Article  PubMed  Google Scholar 

  4. GF Scheumann H Seeliger TJ Musholt et al. (1996) ArticleTitleCompletion thyroidectomy in 131 patients with differentiated thyroid carcinoma Eur. J. Surg. 162 677–684 Occurrence Handle1:STN:280:ByiD28vovFM%3D Occurrence Handle8908447

    CAS  PubMed  Google Scholar 

  5. NF Esnaola SB Cantor SI Sherman et al. (2001) ArticleTitleOptimal treatment strategy in patients with papillary thyroid cancer: a decision analysis Surgery 130 921–930 Occurrence Handle10.1067/msy.2001.118370 Occurrence Handle1:STN:280:DC%2BD3MjgtFeguw%3D%3D Occurrence Handle11742318

    Article  CAS  PubMed  Google Scholar 

  6. ID Hay CS Grant WF Taylor et al. (1987) ArticleTitleIpsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system Surgery 102 1088–1095 Occurrence Handle1:STN:280:BieD2s7itFw%3D Occurrence Handle3686348

    CAS  PubMed  Google Scholar 

  7. ID Hay CS Grant EJ Bergstralh et al. (1996) ArticleTitleUnilateral total lobectomy: is it sufficient surgical treatment for patients with AMES low-risk papillary thyroid carcinoma? Surgery 124 958–966

    Google Scholar 

  8. K Loh FS Greenspan L Gee et al. (1997) ArticleTitlePathological tumor-node-metastasis (pTNM) staging for papillary and follicular thyroid carcinomas: a retrospective analysis of 700 patients J. Clin. Endocrinol. Metab. 82 3553–3562 Occurrence Handle10.1210/jc.82.11.3553 Occurrence Handle1:CAS:528:DyaK2sXnt1elur4%3D Occurrence Handle9360506

    Article  CAS  PubMed  Google Scholar 

  9. S Noguchi A Noguchi N Muracami (1970) ArticleTitlePapillary carcinoma of the thyroid II. Value of prophylactic lymph node excision Cancer 26 1061–1064 Occurrence Handle1:STN:280:CS6D38npslU%3D Occurrence Handle5476787

    CAS  PubMed  Google Scholar 

  10. JN Attie RA Khafif RM Steckler (1971) ArticleTitleElective dissection of the neck in papillary carcinoma of the thyroid Am. J. Surg. 122 464–467 Occurrence Handle10.1016/0002-9610(71)90469-7 Occurrence Handle1:STN:280:CS2D3M3nsFc%3D Occurrence Handle5098652

    Article  CAS  PubMed  Google Scholar 

  11. JA Buckwalter NJ Gurll CG Thomas (1981) ArticleTitleCancer of the thyroid in youth World J. Surg. 5 15–25 Occurrence Handle10.1007/BF01657826 Occurrence Handle1:STN:280:Bi6B3c3mtFY%3D Occurrence Handle7233950

    Article  CAS  PubMed  Google Scholar 

  12. O Ozaki K Ito K Kobayashi et al. (1988) ArticleTitleModified neck dissection for patients with nonadvanced differentiated carcinoma of the thyroid World J. Surg. 12 825–827 Occurrence Handle1:STN:280:BiaB28fnslw%3D Occurrence Handle3250133

    CAS  PubMed  Google Scholar 

  13. JP Travagli D Blazquez M Schlumberger et al. (1983) ArticleTitleLe traitement chirurgical initial des epitheliomas differencies de la thyroide Ann Endoc. 44 273–275 Occurrence Handle1:STN:280:BiuB3c7lvVc%3D

    CAS  Google Scholar 

  14. C Proye A Gontier JL Quievreux et al. (1990) ArticleTitleDecision de curage ganglionnaire en chirurgie du cancer thyroidien Chirurgie 116 290–295 Occurrence Handle1:STN:280:By6C387pt1Q%3D Occurrence Handle2279446

    CAS  PubMed  Google Scholar 

  15. A Ohshima H Yamashita S Noguchi et al. (2000) ArticleTitleIndications for bilateral modified radical neck dissection in patients with papillary carcinoma of the thyroid Arch. Surg. 135 1194–1199 Occurrence Handle1:STN:280:DC%2BD3M%2FitlGgsA%3D%3D Occurrence Handle11030879

    CAS  PubMed  Google Scholar 

  16. GF Scheumann O Gimm G Wegener et al. (1994) ArticleTitlePrognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer World J. Surg. 18 559–568 Occurrence Handle10.1007/BF00353765 Occurrence Handle1:STN:280:ByqB2c3nvVQ%3D Occurrence Handle7725745

    Article  CAS  PubMed  Google Scholar 

  17. L-E Tisell B Nilson J Mölne et al. (1996) ArticleTitleImproved survival of patients with papillary thyroid cancer after surgical microdissection World J. Surg. 20 854–859 Occurrence Handle10.1007/s002689900130 Occurrence Handle1:STN:280:BymH38jitlA%3D Occurrence Handle8678962

    Article  CAS  PubMed  Google Scholar 

  18. O Gimm FW Rath H Dralle (1998) ArticleTitlePattern of lymph node metastases in papillary thyroid carcinoma Br. J. Surg. 85 252–254 Occurrence Handle10.1046/j.1365-2168.1998.00510.x Occurrence Handle1:STN:280:DyaK1c7mt1Cmsw%3D%3D Occurrence Handle9501829

    Article  CAS  PubMed  Google Scholar 

  19. CR McHenry IB Rosen PG Walfish (1991) ArticleTitleProspective management on nodal metastases in differentiated thyroid cancer Am. J. Surg. 162 353 Occurrence Handle10.1016/0002-9610(91)90147-6 Occurrence Handle1:STN:280:By2D2MbntVI%3D Occurrence Handle1951888

    Article  CAS  PubMed  Google Scholar 

  20. IB Rosen A Maitiand (1983) ArticleTitleChanging the operative strategy for thyroid cancer by node sampling Am. J. Surg. 146 504–508 Occurrence Handle1:STN:280:BiuD387lvFM%3D Occurrence Handle6625096

    CAS  PubMed  Google Scholar 

  21. M Salvatori V Rufini F Reale (2003) ArticleTitleRadio-guided surgery for lymph node recurrences of differentiated thyroid cancer World J. Surg. 27 770–775 Occurrence Handle10.1007/s00268-003-7014-8 Occurrence Handle14509503

    Article  PubMed  Google Scholar 

  22. M Ctatarci F Zavaca R Angeloni (2001) ArticleTitlePreoperative lymphoscintigraphy and sentinel lymph node biopsy in papillary thyroid cancer. A pilot study J. Surg. Oncol. 77 21–24

    Google Scholar 

  23. E Dixon JG McKinnon JL Pasieka (2000) ArticleTitleFeasibility of sentinel lymph node biopsy and lymphatic mapping in nodular thyroid neoplasm World J. Surg. 24 1396–1401 Occurrence Handle10.1007/s002680010231 Occurrence Handle1:STN:280:DC%2BD3M%2FlslKguw%3D%3D Occurrence Handle11038213

    Article  CAS  PubMed  Google Scholar 

  24. J Arch-Ferrer D Velazquez R Fajardo (2001) ArticleTitleAccuracy of sentinel lymph node in papillary thyroid carcinoma Surgery 130 907–913 Occurrence Handle10.1067/msy.2001.118372 Occurrence Handle1:STN:280:DC%2BD3MjgtFegtQ%3D%3D Occurrence Handle11742316

    Article  CAS  PubMed  Google Scholar 

  25. JF Moley SA Wells (1999) ArticleTitleCompartment-mediated dissection for papillary thyroid carcinoma Langenbecks Arch. Surg. 384 9–15 Occurrence Handle10.1007/s004230050167 Occurrence Handle1:STN:280:DyaK1M3psVSntg%3D%3D Occurrence Handle10367624

    Article  CAS  PubMed  Google Scholar 

  26. D Simon PE Goretzki J Witte et al. (1996) ArticleTitleIncidence of regional recurrence guiding radicality in differentiated thyroid carcinoma World J. Surg. 20 860–866 Occurrence Handle10.1007/s002689900131 Occurrence Handle1:STN:280:BymH38jitlE%3D Occurrence Handle8678963

    Article  CAS  PubMed  Google Scholar 

  27. E Mirallié J Visset C Sagan et al. (1999) ArticleTitleLocalization of cervical node metastasis of papillary thyroid carcinoma World J. Surg. 23 970–974 Occurrence Handle10449830

    PubMed  Google Scholar 

  28. B Mann HJ Buhr (1998) ArticleTitleLymph node dissection in patients with differentiated thyroid carcinoma. Who benefits? Langenbecks Arch. Surg. 383 355–358 Occurrence Handle10.1007/s004230050148 Occurrence Handle1:STN:280:DyaK1M%2FnsFGktg%3D%3D Occurrence Handle9860231

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Papageorgiou General Hospital, Thessaloniki Ring Road, Nea Eukarpia, 56429, Thessaloniki, Greece

    Apostolos Goropoulos M.D., Konstantinos Karamoshos M.D., Andreas Christodoulou M.D., Theodoros Ntitsias M.D., Konstantinos Paulou M.D. & Asterios Samaras M.D.

  2. Department of Anatomic Pathology, Papageorgiou General Hospital, Thessaloniki Ring Road, Nea Eukarpia, 56429, Thessaloniki, Greece

    Persefoni Xirou M.D. & Ioannis Efstratiou M.D.

Authors
  1. Apostolos Goropoulos M.D.
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  2. Konstantinos Karamoshos M.D.
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  3. Andreas Christodoulou M.D.
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  4. Theodoros Ntitsias M.D.
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  5. Konstantinos Paulou M.D.
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  6. Asterios Samaras M.D.
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  7. Persefoni Xirou M.D.
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  8. Ioannis Efstratiou M.D.
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Correspondence to Apostolos Goropoulos M.D..

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00268-005-1149-8.

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Goropoulos, A., Karamoshos, K., Christodoulou, A. et al. Value of the Cervical Compartments in the Surgical Treatment of Papillary Thyroid Carcinoma. World J. Surg. 28, 1275–1281 (2004). https://doi.org/10.1007/s00268-004-7643-6

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  • DOI: https://doi.org/10.1007/s00268-004-7643-6

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