Elective paratracheal neck dissection for lateral metastases from papillary carcinoma of the thyroid: Is it indicated?

Avi Khafif, Rami Ben-Yosef, Avrum Abergel, Ada Kesler, Roee Landsberg, Dan M. Fliss

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Therapeutic paratracheal neck dissection for patients with papillary carcinoma of the thyroid is standard treatment. Its use as an elective procedure is controversial. Methods. Thirty-seven patients with papillary carcinoma of the thyroid and evidence of positive adenopathy at levels II-V underwent selective neck dissection and elective/therapeutic paratracheal neck dissection. Results of preoperative ultrasonography of the neck were compared with the dissection specimens. Results. Morbidity of the surgical procedure was minimal (1 permanent hypocalcemia). All specimens showed metastases from papillary thyroid carcinoma: 100% (37/37) in the jugular chain of lymphatics and 83.7% (31/37) in the paratracheal region. The rate of occult (negative physical examination and ultrasonography) metastases in the paratracheal region in the presence of metastases in the ipsilateral jugular chain was 83.3% (20/24). Conclusion. The high rate of occult metastases in the paratracheal region and the low rate of surgical morbidity speak in favor of elective paratracheal neck dissection in patients with metastatic papillary carcinoma of the thyroid.

Original languageEnglish
Pages (from-to)306-310
Number of pages5
JournalHead and Neck
Volume30
Issue number3
DOIs
StatePublished - Mar 2008

Keywords

  • Elective
  • Metastases
  • ND
  • Papillary carcinoma
  • Paratracheal

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