Faculty Collaboration Database

Institutional experience with lateral neck dissections for thyroid cancer. Surgery 2015 Oct;158(4):972-8; discussion 978-80

Date

07/19/2015

Pubmed ID

26187683

DOI

10.1016/j.surg.2015.03.066

Scopus ID

2-s2.0-84940775476 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

INTRODUCTION: Compartment-oriented neck dissection is recommended for patients with evidence of thyroid cancer metastases to lateral compartment lymph nodes. This study reviews the outcomes of patients who underwent lateral neck dissections (LND) at a high-volume institution.

METHODS: This is a retrospective review of patients who underwent LND for metastatic thyroid cancer from January 2009 to June 2014. Preoperative evaluation, operative findings, and postoperative outcomes were analyzed.

RESULTS: Ninety-six patients underwent 127 LNDs. Fine-needle aspiration (FNA) confirmed metastases in 82 lateral necks (65%). The remaining 45 LNDs (35%) were performed based on clinical suspicion of metastases; 29 (64%) had metastases on final pathology. Twenty patients had 26 complications, which included chyle leak (7 [6%]), spinal accessory nerve dysfunction (7 [6%]), neck seroma requiring drainage (2 [2%]), and surgical site infection (10 [8%]).

CONCLUSION: LND is associated with a risk of early postoperative morbidity, but long-term complications are uncommon in the hands of experienced surgeons. In patients with thyroid cancer, a comprehensive preoperative evaluation of the lateral neck with physical examination, ultrasonography, and possible FNA should be performed. For those with suspicion of metastases, LND can be an important therapeutic option, but discussion with the patient regarding potential risks and benefits is essential.

Author List

Glenn JA, Yen TW, Fareau GG, Carr AA, 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
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

Adenoma, Oxyphilic
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma
Carcinoma, Neuroendocrine
Carcinoma, Papillary
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neck Dissection
Postoperative Complications
Retrospective Studies
Thyroid Carcinoma, Anaplastic
Thyroid Neoplasms
Treatment Outcome
Young Adult