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The clinical significance of lymph node involvement in thyroid

Author(s): Sevim Turanlı

Journal: Journal of Dialog in Endocrinology
ISSN 1306-2514

Volume: 9;
Issue: 1;
Start page: 12;
Date: 2012;
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Keywords: thyroid carcinoma | distant metastasis | lymph

Aim: To confirm the clinical significance of cervicallymph node metastasis in papillary thyroid cancer patientswith distant metastasis at the time of diagnosisand to examine the location of prophylactic dissection.Materials and methods: Hospital records of 25 consecutivepatients treated between 1998-2010 were analyzedretrospectively. Patients were grouped in terms of thepresence of lymph node metastasis at the time of diagnosis,where patients with lymph node metastasis besidesdistant metastasis composed group I (n=16patients, 64%), while patients with distant metastasisonly composed group II (n=9 patients, 36%). Total thyroidectomywas applied at the time of diagnosis, or inmedian two months following the primary surgery if thepatients already had a thyroidectomy less than total.Therapeutic neck dissection was performed on 16 patientswhich had lymph node metastasis.Results: Of all patients, 19 (76%) were female and therest were male. Mean ages of the patients in group I andII were 36 and 54, respectively, and the age distributionwithin groups was different (p=0.01). The majority(56%) of tumors consisted of T3 tumors. The percentagesof isolated lung, multiple organ and isolated bonemetastasis at the time of diagnosis were 64%, 28%, and8%, respectively. The patients were followed-up for median70 months (range: 11-146 months) and progressionwas detected in 10 (40%) patients. The time of progressionin group I and II were 56 and 70 months, respectively(p=0.31). Among the patients, 6 (24%) were lostdue to reasons related to the disease. The presence oflymph node metastasis in patients with distant metastasiswas not effective on overall survival (p=0.53).Conclusion: When therapeutic lymph node dissectionwas performed in thyroid cancer patients with distantmetastasis, the obtained progression-free and overallsurvival durations are similar to patients without lymphnode involvement. We do not recommend prophylacticdissection, despite the high risk of lymph node metastasisin these patients.

Tango Jona
Tangokurs Rapperswil-Jona

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