Kim Heejin, Jin Young Ju, Cha Wonjae, Jeong Woo-Jin, Ahn Soon-Hyun
Department of Otorhinolaryngology - Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Head Neck. 2014 Apr;36(4):487-91. doi: 10.1002/hed.23320. Epub 2013 Jun 1.
Therapeutic lateral compartment neck dissection is recommended for cases of papillary thyroid carcinoma with biopsy-proven lymph node metastasis. The purpose of this study was to evaluate the efficacy and safety of super-selective neck dissection for patients with clinically suspicious lymph node metastasis not confirmed by biopsy.
Among 620 patients treated for papillary thyroid carcinoma between 2008 and 2010, 34 had suspicious lymph node enlargement in the lateral neck and underwent total thyroidectomy with super-selective neck dissection.
Metastatic disease was confirmed in 38.2% patients (13 of 34) with indeterminate lymph nodes identified by preoperative CT and/or ultrasonography who underwent super-selective neck dissection. Most harvested lymph nodes were located at level IV. There was no recurrence during a mean follow-up period of 31.6 months.
Patients with clinically suspicious lateral neck nodes that are not confirmed by biopsy may be good candidates for super-selective neck dissection, which had minimal morbidity and did not compromise oncologic outcomes.
对于经活检证实有淋巴结转移的乳头状甲状腺癌病例，推荐进行治疗性侧颈部淋巴结清扫术。本研究的目的是评估超选择性颈部清扫术对临床怀疑有淋巴结转移但未经活检证实的患者的疗效和安全性。
在2008年至2010年间接受乳头状甲状腺癌治疗的620例患者中，34例侧颈部有可疑淋巴结肿大，并接受了全甲状腺切除术加超选择性颈部清扫术。
在接受超选择性颈部清扫术的患者中，术前CT和/或超声检查发现不确定淋巴结的患者中，38.2%（34例中的13例）确诊有转移性疾病。大多数切除的淋巴结位于IV区。在平均31.6个月的随访期内无复发。
临床怀疑侧颈部淋巴结但未经活检证实的患者可能是超选择性颈部清扫术的良好候选者，该手术发病率极低且不影响肿瘤治疗效果。
