Jugular lymph node-confusion of regional lymph node dissection in thyroid carcinoma

Abstract

Objective To investigate the risk factors, treatment methods and significance of the cervical venous angle lymph node metastasis in differentiated thyroid cancer. Methods The clinical data of 222 patients with thyroid papillary carcinoma from December 2012 to January 2014 were collected. The surgical methods, complications and postoperative complications and pathology were analyzed. Results Lymph node metastasis was found in 133 cases. when VI lymph node was positive, the lateral cervical lymph node positive rate was 43%(57/133) in Ⅱ District, 54%(72/133) in Ⅲ District, Ⅳ District 45%(60/133) in Ⅳ District, 60%(80/133) in jugular angle, and 6%(8/133) in V District. The levels of bleeding volume, operation time and hospitalization time in functional neck dissection (FND) group were significantly higher than those in anterior cervical muscle group and reserved anterior cervical muscle group (P<0.05). Single factor analysis showed that diameter of the tumors, thyroid membrane invasion and central region lymph node metastasis had correlations with venous angle lymph metastasis (P<0.01). Logistic regression analysis showed that thyroid membrane invasion (OR= 3.539), central region lymph node metastasis (OR= 1.617), diameters of the tumors (OR= 1.321)were the risk factors of cervical venous angle lymph node metastasis. Conclusions Patients with tumor diameter equal to or more than 1.5 cm, thyroid membrane invasion and lymph node metastasis number greater than or equal to 2 should be performed with lateral neck lymph node dissection. Also the venous angle lymph node dissection should be done in these patients so as to increase radical rate. Key words: Thyroid neoplasms; Neck dissection; Venous angle lymph node