Abstract | BACKGROUND: METHODS: We completed a retrospective review of patients with thyroid cancer who underwent selective LCND from 1992-2012 to determine the extent of lymph node resection, morbidity, recurrence, subsequent operations, mortality, and duration of follow-up. RESULTS: A total of 45 LCNDs (five bilateral) were performed in 40 patients, 35 with differentiated thyroid cancer (DTC) and five with medullary carcinoma. Nineteen LCNDs (42%) were completed at the time of thyroidectomy. Levels IIA, III, IV, and VB were included in 43 LCNDs (96%) and levels IIA, III, and IV in two LCNDs (4%). Morbidity included neck or ear numbness in 19 patients (48%), neuropathic symptoms in 14 (35%), Horner syndrome in two (5%), marginal mandibular nerve paresis in two (5%), and wound infection in one (3%). Recurrence rate was 25% (10 patients) and one or more reoperations were performed in seven patients (18%) with a mean follow-up of 58 ± 60 mo (range, 1-244 mo). There were 3 ipsilateral recurrences (8%) after 40 LCNDs for DTC. Four patients died from systemic disease: three with medullary carcinoma and one with PTC. CONCLUSIONS: Selective LCND is an effective therapeutic strategy for macroscopic lymph node metastases, with an 8% recurrence rate in the ipsilateral neck in patients with DTC. Neuropathic symptoms, however, remain an important source of morbidity.
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Authors | Kellen Welch, Christopher R McHenry |
Journal | The Journal of surgical research
(J Surg Res)
Vol. 184
Issue 1
Pg. 193-9
(Sep 2013)
ISSN: 1095-8673 [Electronic] United States |
PMID | 23816244
(Publication Type: Journal Article)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Topics |
- Adenocarcinoma, Follicular
(mortality, secondary, surgery)
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Medullary
(mortality, secondary, surgery)
- Carcinoma, Papillary
(mortality, secondary, surgery)
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision
(methods)
- Lymph Nodes
(anatomy & histology, surgery)
- Lymphatic Metastasis
- Male
- Middle Aged
- Morbidity
- Neck Dissection
(methods)
- Neck Muscles
(anatomy & histology, surgery)
- Neoplasm Recurrence, Local
(mortality, pathology, surgery)
- Retrospective Studies
- Thyroid Neoplasms
(mortality, pathology, surgery)
- Thyroidectomy
(methods)
- Young Adult
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