Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection
Abstract Background Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection. Methods We performed a retrospective medical record review of PTC patients with...
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SAGE Publishing
2017-05-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-017-0221-3 |
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| author | Jason J. Xu Eugene Yu Caitlin McMullen Jesse Pasternak Jim Brierley Richard Tsang Han Zhang Antoine Eskander Lorne Rotstein Anna M. Sawka Ralph Gilbert Jonathan Irish Patrick Gullane Dale Brown John R. de Almeida David P. Goldstein |
| author_facet | Jason J. Xu Eugene Yu Caitlin McMullen Jesse Pasternak Jim Brierley Richard Tsang Han Zhang Antoine Eskander Lorne Rotstein Anna M. Sawka Ralph Gilbert Jonathan Irish Patrick Gullane Dale Brown John R. de Almeida David P. Goldstein |
| author_sort | Jason J. Xu |
| collection | DOAJ |
| description | Abstract Background Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection. Methods We performed a retrospective medical record review of PTC patients with lateral neck nodal metastases treated at University Health Network from 2000 to 2012. Predictive factors for regional neck recurrence, including extent of initial neck dissection, were analyzed using Cox regression. Results Out of 204 neck dissections in 178 patients, 110 (54%) underwent selective and 94 (46%) had comprehensive dissection including level Vb. Mean follow-up was 6.3 years (SD). Significant predictors of regional failure were the total number of suspicious nodes on preoperative imaging (p = 0.029), largest positive node on initial neck dissection (p < 0.01), and whether patients received adjuvant radiotherapy (p = 0.028). The 5-year ipsilateral regional recurrence rate was 8 and 9% with selective and comprehensive dissection, respectively (p = 0.89). Conclusion The extent of neck dissection did not predict the probability of regional recurrence in PTC patients presenting with lateral neck metastases. |
| format | Article |
| id | doaj-art-a5c71fb6b70f4ca4bcc52078f5fa621b |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2017-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-a5c71fb6b70f4ca4bcc52078f5fa621b2025-02-03T00:22:57ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162017-05-014611710.1186/s40463-017-0221-3Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissectionJason J. Xu0Eugene Yu1Caitlin McMullen2Jesse Pasternak3Jim Brierley4Richard Tsang5Han Zhang6Antoine Eskander7Lorne Rotstein8Anna M. Sawka9Ralph Gilbert10Jonathan Irish11Patrick Gullane12Dale Brown13John R. de Almeida14David P. Goldstein15Department of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Medical Imaging, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Surgery, Division of General Surgery, University Health Network, University of TorontoDepartment of Radiation Oncology, University Health Network, University of TorontoDepartment of Radiation Oncology, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Surgery, Division of General Surgery, University Health Network, University of TorontoDepartment of Medicine, Division of Endocrinology, University Health Network University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoDepartment of Otolaryngology—Head and Neck Surgery, University Health Network, University of TorontoAbstract Background Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection. Methods We performed a retrospective medical record review of PTC patients with lateral neck nodal metastases treated at University Health Network from 2000 to 2012. Predictive factors for regional neck recurrence, including extent of initial neck dissection, were analyzed using Cox regression. Results Out of 204 neck dissections in 178 patients, 110 (54%) underwent selective and 94 (46%) had comprehensive dissection including level Vb. Mean follow-up was 6.3 years (SD). Significant predictors of regional failure were the total number of suspicious nodes on preoperative imaging (p = 0.029), largest positive node on initial neck dissection (p < 0.01), and whether patients received adjuvant radiotherapy (p = 0.028). The 5-year ipsilateral regional recurrence rate was 8 and 9% with selective and comprehensive dissection, respectively (p = 0.89). Conclusion The extent of neck dissection did not predict the probability of regional recurrence in PTC patients presenting with lateral neck metastases.http://link.springer.com/article/10.1186/s40463-017-0221-3Papillary thyroid carcinomaNeck dissectionRegional recurrence |
| spellingShingle | Jason J. Xu Eugene Yu Caitlin McMullen Jesse Pasternak Jim Brierley Richard Tsang Han Zhang Antoine Eskander Lorne Rotstein Anna M. Sawka Ralph Gilbert Jonathan Irish Patrick Gullane Dale Brown John R. de Almeida David P. Goldstein Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection Journal of Otolaryngology - Head and Neck Surgery Papillary thyroid carcinoma Neck dissection Regional recurrence |
| title | Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection |
| title_full | Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection |
| title_fullStr | Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection |
| title_full_unstemmed | Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection |
| title_short | Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection |
| title_sort | patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection |
| topic | Papillary thyroid carcinoma Neck dissection Regional recurrence |
| url | http://link.springer.com/article/10.1186/s40463-017-0221-3 |
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