Patterns of Lateral Lymph Node Metastasis in Papillary Thyroid Cancer

Abstract

Objective: Analyze the patterns and factors of lateral lymph node metastasis in papillary thyroid cancer (PTC) patients. Based on this, we can suggest the optimal surgical extent of neck dissection for PTC patients with lateral compartment lymph node metastasis. Method: From January 2000 to December 2009, the patient group consisted of 88 patients who underwent total thyroidectomy concomitant therapeutic neck dissection. A total of 86 (97.7%) patients confirmed as having PTC and lateral compartment neck metastasis by pathologic examination were enrolled this study. Results: A total of 86 patients underwent 100 lateral compartment neck dissection. Level IV was found to be the predominant site for lateral compartment lymph node metastasis (83%). Level III, Level II, and Level V were 65%, 54%, 17%, respectively. Level VI lymph node metastasis was found in 84.9% (73/86). Multiple level nodal metastasis was correlated with lymphovascular invasion of PTC. Skip metastasis was correlated with age. Conclusion: In PTC patients with lateral nodal invasion, total thyroidectomy concomitant bilateral central compartment neck dissection and ipsilateral lateral compartment neck dissection including Levels II-V may be the optimal treatment.