Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA.
Otolaryngol Head Neck Surg. 2020 Jan;162(1):50-55. doi: 10.1177/0194599819886123. Epub 2019 Oct 29.
To establish the association between lymph node yield and ratio in neck dissection for well-differentiated thyroid cancer and risk for persistent postoperative disease.
Retrospective cohort study of patients undergoing lymphadenectomy for thyroid carcinoma.
Tertiary referral center.
Included patients underwent central and/or lateral neck dissection for papillary thyroid carcinoma at our institution between 1994 and 2015. They were divided into a persistent disease group with biochemical and structural disease (49 patients) and a disease-free group with no disease after a minimum 2 years of follow-up (175 patients). Demographic characteristics, adjuvant therapy, tumor, and lymph node features were compared.
There were no significant differences in demographic characteristics between the groups. The mean nodal yield of patients with central and lateral neck persistence was significantly lower than that of patients remaining disease free (4.8 vs. 11.9: odds ratio [OR] 0.69; 95% CI, 0.59 to 0.8; < .001; 14.8 vs. 31.0: OR, 0.89; 95% CI, 0.84-0.94; < .001, respectively). Nodal ratio was higher in patients with persistence in the central and lateral neck (74.2% vs 29.4%: OR, 1.06; 95% CI, 1.04-1.08; < .001; 54.2% vs 19.8%: OR, 1.08; 95% CI, 1.04-1.12; < .001, respectively).
Lower lymph node yield and higher node ratio from cervical lymph node dissections are associated with persistent disease and have potential applications in surgical adequacy.
探讨分化型甲状腺癌颈清扫术淋巴结检出数与检出率与术后持续性疾病的关系。
对在我院行颈淋巴结清扫术的甲状腺癌患者进行回顾性队列研究。
三级转诊中心。
纳入 1994 年至 2015 年在我院行中央区和/或侧颈区淋巴结清扫术的患者。根据术后是否存在生化或结构疾病将患者分为持续性疾病组（49 例）和无疾病组（175 例）。比较两组患者的人口统计学特征、辅助治疗、肿瘤和淋巴结特征。
两组患者的人口统计学特征无显著差异。中央区和侧颈区持续性疾病患者的淋巴结检出总数明显低于无疾病患者（4.8 枚比 11.9 枚：比值比[OR] 0.69；95%置信区间，0.59 至 0.8； < 0.001；14.8 枚比 31.0 枚：OR 0.89；95%置信区间，0.84 至 0.94； < 0.001）。中央区和侧颈区持续性疾病患者的淋巴结检出率更高（74.2%比 29.4%：OR 1.06；95%置信区间，1.04 至 1.08； < 0.001；54.2%比 19.8%：OR 1.08；95%置信区间，1.04 至 1.12； < 0.001）。
颈淋巴结清扫术的淋巴结检出数和检出率较低与持续性疾病相关，可能对评估手术充分性有一定作用。
