Faculty Collaboration Database

The Effect of Thyroiditis on the Yield of Central Compartment Lymph Nodes in Patients with Papillary Thyroid Cancer. Ann Surg Oncol 2015 Dec;22(13):4181-6

Date

04/09/2015

Pubmed ID

25851341

DOI

10.1245/s10434-015-4551-y

Scopus ID

2-s2.0-84947128282 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: In patients who have undergone thyroidectomy and central compartment neck dissection (CCND) for papillary thyroid cancer (PTC), visualization of enlarged lymph nodes may lead to more extensive CCND. This study sought to determine the effect of patient age and the presence of thyroiditis on the number of malignant and total lymph nodes resected in patients who underwent CCND for PTC.

METHODS: This retrospective review examined a prospective database of patients who underwent total thyroidectomy and CCND for PTC between April 2009 and June 2013 and had thyroiditis on the final pathology. The patients were categorized into age groups by decade (18-29, 30-39, 40-49, 50-59, and ≥60 years) and compared with a control group of patients matched by age, gender, and tumor size.

RESULTS: Of 74 patients with thyroiditis, 64 (87 %) were women. The median age of the patients was 47.5 years (range 18.2-72.0 years). The patients with thyroiditis had more lymph nodes resected than those without thyroiditis (median 11 vs 7; p < 0.01). However, these patients had fewer malignant lymph nodes (median 0 vs 1.5; p = 0.06), resulting in a lower lymph node ratio (0 vs 0.18; p = 0.02) for the entire cohort, but particularly for the youngest (18-29 years) and oldest (≥60 years) age groups.

CONCLUSIONS: Patients with thyroiditis and PTC who underwent CCND had more lymph nodes resected but a had lower proportion of metastatic lymph nodes than those without thyroiditis. Given the relatively low yield of malignant cervical lymphadenopathy, a more judicious approach to CCND might be considered, particularly for the youngest and oldest patients with PTC and thyroiditis.

Author List

Lai V, Yen TW, Rose BT, Fareau GG, Misustin SM, Evans DB, Wang TS

Authors

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Gilbert G. Fareau MD Associate Professor in the Medicine department at Medical College of Wisconsin
Sarah Misustin APP Inpatient 1 in the Surgery department at Medical College of Wisconsin
Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Carcinoma, Papillary
Female
Follow-Up Studies
Humans
Lymph Node Excision
Lymph Nodes
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Prognosis
Prospective Studies
Retrospective Studies
Thyroid Neoplasms
Thyroidectomy
Thyroiditis
Young Adult