Lateral neck recurrence from papillary thyroid carcinoma: Predictive factors and prognostic significance. (15th December 2014)

• Record Type: Journal Article
• Authors: Giordano, Davide; Frasoldati, Andrea; Kasperbauer, Jan L.; Gabrielli, Enrico; Pernice, Carmine; Zini, Michele; Pedroni, Corrado; Cavuto, Silvio; Barbieri, Verter
• Is Part Of: Laryngoscope. Volume 125:Number 9(2015:Sep.)
• Page Start: 2226
• Page End: 2231
• Publication Date: 2014-12-15
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.25094
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary25094-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>The aim of this study was to identify any possible predictive factors of lateral neck recurrence in patients with papillary thyroid carcinoma with no ultrasonographic and/or cytological evidence of lymph node metastasis at time of diagnosis. The influence of lateral neck recurrence on survival was also investigated.</p> </sec> <sec id="lary25094-sec-0002" sec-type="section"> <title>Study Design</title> <p>Observational retrospective study.</p> </sec> <sec id="lary25094-sec-0003" sec-type="section"> <title>Methods</title> <p>Retrospective review of clinical records of 610 patients surgically treated for papillary thyroid carcinoma with clinically negative lymph nodes at the Otolaryngology Unit of the Arcispedale Santa Maria Nuova–IRCCS, Reggio Emilia, Italy, from January 1984 to December 2008.</p> </sec> <sec id="lary25094-sec-0004" sec-type="section"> <title>Results</title> <p>Lateral neck recurrences were ipsilateral to the primary tumor in all cases and were associated with the occurrence of more aggressive histological variants and central neck metastasis. Lateral neck recurrences were more frequently observed in patients with distant metastases and were associated with a reduced disease‐specific survival.</p> </sec> <sec id="lary25094-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Lateral neck compartment ipsilateral to the tumor was the most common site of recurrence, with about half of cases appearing in the first 28 months of follow‐up. In patients with papillary thyroid carcinoma, detection of lateral neck metastases prior to first surgery is crucial to surgical planning. Aggressive histological variants and postsurgical evidence of lymph node metastasis from papillary thyroid carcinoma in central neck compartment are associated with a higher risk of lateral neck recurrence. In these patients, a closer postsurgical ultrasound surveillance of the lateral neck compartments seems worthwhile.</p> </sec> <sec id="lary25094-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4. <italic>Laryngoscope</italic>, 125:2226–2231, 2015</p> </sec> </abstract>