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7 - The risk factors for contralateral paratracheal lymph node metastases in papillary thyroid cancer
Evren Besler, Nurcihan Aygun, Emre Bozdag, Bulent Citgez, Sitki Gurkan Yetkin, Mehmet Mihmanli, Mehmet Uludag
Objective: Lymph node metastasis is frequently seen in papillary thyroid cancer. In the present study, we aimed to evaluate the rate and risk factors for the contralateral paratracheal lymph node metastasis in papillary thyroid cancer and to evaluate the effect of risk factors on the extent of the lymphatic dissection.
Materials and Methods: Twenty-seven patients (19 female, 8 male) with a median age of 44 (range 16-75), who underwent total thyroidectomy with central neck dissection with or without therapeutical lateral neck dissection were examined. The effects of the age, gender, extrathyroidal extension, multifocality, bilaterality, lymphovascular invasion, T stage, prelaryngeal, pretracheal, ipsilateral paratracheal and lateral lymph node metastasis on the contralateral paratracheal metastasis were evaluated. Chi-square and Fishers exact tests were used for statistical analyses.
Results: All patients underwent total thyroidectomy with bilateral central neck dissection. Additionally 12 patients out of 27 underwent therapeutical lateral neck dissection. T stages were classified as T1: 16 (59.3%), T2: 7 (25.9%), T3: 4 (14.8%) respectively. The occurance of contralateral paratracheal metastasis was found significantly higher in the cases having lateral metastasis (100% vs 47.6; p=0.05).
Conclusions: Lymph node metastasis is frequently seen in papillary thyroid cancer and primarily occurs in the ipsilateral paratracheal area. The rate of contralateral paratracheal metastasis is higher in the patients with lateral lymph node metastasis. The lateral lymph node metastases detected pre or peroperatively should be considered for the bilateral central neck dissection.
Keywords: Contralateral paratracheal, lymph node, metastasis, papillary thyroid cancer
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