Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma.

Abstract:

OBJECTIVE:To analyze the yield and rate of node metastases (pN1) for prophylactic central (CND) and lateral neck dissection (LND) for papillary thyroid carcinoma, the risk factors for pN1, and outcomes. BACKGROUND:Prophylactic CND and LND are not routinely employed. Adjuvant radioiodine treatment may be modulated, however, by surgical staging of the neck. METHODS:Retrospective study, consecutive patients ultrasonographically classified cN0 treated with prophylactic CND, and lateral LND (levels III and IV). The number of nodes was resected and the incidence of pN1 was recorded. RESULTS:For 317 patients (254 women, mean age 44 years, mean tumor size 17 mm), the number of lymph nodes was 5 for unilateral CND, 9 for bilateral CND, and 12 for LND. pN1 stage was 42% overall: 23% for unilateral CND, 39% for bilateral CND, and 23% for LND (median number of metastatic nodes = 2 for each). Fifty-five percent of the patients staged pN1 had metastatic nodes in the lateral neck. Ten percent had more than 10 metastatic nodes and/or more than 3 nodes with extra capsular spread. pN1 was correlated with tumor size (P = 0.0025), extrathyroidal tumor extension (P < 0.0001), male sex (P = 0.0006), and age younger than 45 years (P = 0.0003). Permanent hypoparathyroidism and unintentional recurrent nerve paralysis occurred in 2 cases each. Patients staged pN0 received less radioiodine than patients staged pN1 (median 30 vs 100 mCi, P < 0.0001). CONCLUSIONS:For staging, bilateral prophylactic CND is preferable to unilateral CND. Prophylactic CND with LND optimizes staging providing a basis for a personalized approach for adjuvant radioiodine.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Hartl DM,Leboulleux S,Al Ghuzlan A,Baudin E,Chami L,Schlumberger M,Travagli JP

doi

10.1097/SLA.0b013e31824b7b68

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

777-83

issue

4

eissn

0003-4932

issn

1528-1140

pii

00000658-201204000-00024

journal_volume

255

pub_type

杂志文章
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    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199911000-00008

    authors: Kosuge T,Yamamoto J,Shimada K,Yamasaki S,Makuuchi M

    更新日期:1999-11-01 00:00:00

  • Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.

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    doi:10.1097/SLA.0000000000002089

    authors: Johnston MJ,Arora S,King D,Darzi A

    更新日期:2018-01-01 00:00:00

  • Clinical effect of allopurinol on preserved kidneys: a randomized double-blind study.

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-197701000-00021

    authors: Toledo-Pereyra LH,Simmons RL,Olson LC,Najarian JS

    更新日期:1977-01-01 00:00:00

  • Complications of vagotomy in the treatment of hiatal hernia.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197606000-00003

    authors: Vansant JH,Baker JW Jr

    更新日期:1976-06-01 00:00:00

  • Laparoscopic repair of very large hiatus hernia with sutures versus absorbable mesh versus nonabsorbable mesh: a randomized controlled trial.

    abstract:OBJECTIVE:Determine whether absorbable or nonabsorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared with suture repair. BACKGROUND:Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. P...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000842

    authors: Watson DI,Thompson SK,Devitt PG,Smith L,Woods SD,Aly A,Gan S,Game PA,Jamieson GG

    更新日期:2015-02-01 00:00:00

  • Pylorus Resection Does Not Reduce Delayed Gastric Emptying After Partial Pancreatoduodenectomy: A Blinded Randomized Controlled Trial (PROPP Study, DRKS00004191).

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    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000002480

    authors: Hackert T,Probst P,Knebel P,Doerr-Harim C,Bruckner T,Klaiber U,Werner J,Schneider L,Michalski CW,Strobel O,Ulrich A,Diener MK,Büchler MW

    更新日期:2018-06-01 00:00:00

  • A randomized, controlled, double-blind crossover study on the effects of 1-L infusions of 6% hydroxyethyl starch suspended in 0.9% saline (voluven) and a balanced solution (Plasma Volume Redibag) on blood volume, renal blood flow velocity, and renal corti

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    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000000324

    authors: Chowdhury AH,Cox EF,Francis ST,Lobo DN

    更新日期:2014-05-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.sla.0000151791.93571.70

    authors: Nguyen NT,Wolfe BM

    更新日期:2005-02-01 00:00:00

  • Differences in healing of skin wounds caused by burn and freeze injuries.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198002000-00019

    authors: Li AK,Ehrlich HP,Trelstad RL,Koroly MJ,Schattenkerk ME,Malt RA

    更新日期:1980-02-01 00:00:00

  • The Unconventional Role for Gastric Volume in the Response to Bariatric Surgery for Both Weight Loss and Glucose Lowering.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003240

    authors: Evers SS,Lewis AG,Tong C,Shao Y,Alvarez R,Ridelman E,Grant B,Seeley RJ

    更新日期:2020-06-01 00:00:00

  • Major liver resection for hilar cholangiocarcinoma.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198802000-00002

    authors: Bengmark S,Ekberg H,Evander A,Klofver-Stahl B,Tranberg KG

    更新日期:1988-02-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

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    authors: Morino M,Rimonda R,Allaix ME,Giraudo G,Garrone C

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003038

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

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    更新日期:1992-06-01 00:00:00

  • The use of transcutaneous oxygen tension measurements in the diagnosis of peripheral vascular insufficiency.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198408000-00007

    authors: Byrne P,Provan JL,Ameli FM,Jones DP

    更新日期:1984-08-01 00:00:00

  • Vaccinia virus GLV-1h153 is effective in treating and preventing metastatic triple-negative breast cancer.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182654572

    authors: Gholami S,Chen CH,Lou E,De Brot M,Fujisawa S,Chen NG,Szalay AA,Fong Y

    更新日期:2012-09-01 00:00:00

  • Analysis of long-term outcomes of 3200 liver transplantations over two decades: a single-center experience.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000164077.77912.98

    authors: Busuttil RW,Farmer DG,Yersiz H,Hiatt JR,McDiarmid SV,Goldstein LI,Saab S,Han S,Durazo F,Weaver M,Cao C,Chen T,Lipshutz GS,Holt C,Gordon S,Gornbein J,Amersi F,Ghobrial RM

    更新日期:2005-06-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/00000658-199612000-00011

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    更新日期:1996-12-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003768

    authors: Kamenskiy A,Aylward P,Desyatova A,DeVries M,Wichman C,MacTaggart J

    更新日期:2020-01-03 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318211cc0f

    authors: Bilimoria KY,Ko CY,Tomlinson JS,Stewart AK,Talamonti MS,Hynes DL,Winchester DP,Bentrem DJ

    更新日期:2011-04-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198009000-00009

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    更新日期:1980-09-01 00:00:00

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    pub_type: 杂志文章,随机对照试验

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    更新日期:2011-06-01 00:00:00

  • An in vitro evaluation of the stability of mechanical properties of surgical suture materials in various pH conditions.

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    pub_type: 杂志文章

    doi:10.1097/00000658-198308000-00019

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    doi:10.1097/00000658-199112000-00010

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    pub_type: 杂志文章

    doi:10.1097/00000658-197702000-00005

    authors: O'Donnell TF Jr

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  • Defining the "Tipping Point" to Success as a Surgeon-Scientist: An Analysis of Applicants and Awardees of the American College of Surgeons Jacobson Promising Investigator Award.

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    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004142

    authors: Emamaullee J,Lian T,Moroz S,Zuckerbraun B,Matthews J,Gosain A

    更新日期:2020-07-07 00:00:00

  • Effect of optimization of hemodynamics on fibrinolytic activity and antithrombotic efficacy of external pneumatic calf compression.

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-198711000-00014

    authors: Salzman EW,McManama GP,Shapiro AH,Robertson LK,Donovan AS,Blume HW,Sweeney J,Kamm RD,Johnson MC,Black PM

    更新日期:1987-11-01 00:00:00

  • Primary payer status affects mortality for major surgical operations.

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181e8fd75

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    更新日期:2010-09-01 00:00:00