Skip Lateral Neck Node Metastases in Papillary Thyroid Carcinoma

• Published in: World journal of surgery Vol. 36; no. 4; pp. 743 - 747
• Main Authors: Park, Jae Hyun, Lee, Yong Sang, Kim, Bup Woo, Chang, Hang-Seok, Park, Cheong Soo
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.04.2012; Springer‐Verlag; Springer Nature B.V
• Subjects: Abdominal Surgery; Adenocarcinoma, Papillary - pathology; Adenocarcinoma, Papillary - surgery; Adult; Aged; Cardiac Surgery; Central Compartment; Female; General Surgery; Humans; Lateral Compartment; Lateral Neck; Lymph nodes; Lymph Nodes - pathology; Lymphatic Metastasis; Male; medical records; Medicine; Medicine & Public Health; Metastases; Middle Aged; Neck; Neck Dissection; Papillary Thyroid Carcinoma; Radicals; Retrospective Studies; Surgery; Thoracic Surgery; Thyroid Cancer; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy; Tumors; Vascular Surgery; Young Adult; Papillary Thyroid Carcinoma; Lateral Neck; Central Compartment; Thyroid Cancer; Lateral Compartment
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-012-1476-5

Background Papillary thyroid carcinomas (PTCs) are commonly associated with lymph node metastases (LNMs), which are thought to disseminate sequentially, first to the central compartment and later to the lateral compartment. However, a small number of patients have skip metastases to the lateral compartment without central LNMs. This study was performed to evaluate the clinicopathologic characteristics of skip metastases in PTC. Methods We reviewed the medical records of 147 patients who underwent total thyroidectomy with central neck dissection plus modified radical neck dissection (RND) for PTC. A single surgeon performed all operations. The patients were classified as either present or absent skip metastases. The clinicopathologic characteristics were statistically analyzed. Results Skip metastases were found in 32 patients (21.8%) and occurred commonly with primary tumors of the upper pole, and with tumors ≤1 cm in diameter. Skip metastases were less common in patients with multifocal disease. Patients with skip metastases had fewer metastatic lateral nodes that were more frequently found at a single level: mostly at level III (96.9%) and level II (34.4%). Conclusions Although skip metastases occur in only a small number of patients, the lateral compartment should be carefully evaluated for skip metastases, even though primary tumors are either single focus, located in the upper pole, or ≤1 cm in diameter.