Outcome of Cervical Lymph Nodes Dissection for Thyroid Cancer with Nodal Metastases: A Southeast Asian 3-Year Experience.

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2019-02-28 eCollection Date: 2019-01-01 DOI:10.1155/2019/6109643
Raymond Z M Lim, Juin Y Ooi, Jih H Tan, Henry C L Tan, Seniyah M Sikin
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引用次数: 2

Abstract

Introduction: Therapeutic nodal dissection is still the mainstay of treatment for patients with lymph node metastases in many centres. The local data, however, on the outcome of therapeutic LND remains limited. Hence, this study aims to inform practice by presenting the outcomes of LND for thyroid cancer patients and our experience in a tertiary referral centre.

Methods: This is a single-centre retrospective observational study in a Malaysian tertiary endocrine surgery referral centre. Patients who underwent total thyroidectomy with lymph node dissection between years 2013 and 2015 were included and electronic medical records over a 3-year follow-up period were reviewed. The outcomes of different lymph node dissection (LND), including central neck dissection, lateral neck dissection, or both, were compared.

Results: Of the 43 subjects included, 28 (65.1%) had Stage IV cancer. Among the 43 subjects included, 8 underwent central LND, and 15 had lateral LND while the remaining 20 had dissection of both lateral and central lymph nodes. Locoregional recurrence was found in 16 (37.2%) of our subjects included, with no statistical difference between the central (2/8), lateral (7/15), and both (7/20). Postoperative hypocalcaemia occurred in 7 (16.3%) patients, and vocal cord palsy occurred in 5 (11.6%), whereas 9 patients (20.9%) required reoperation. Death occurred in 4 of our patients.

Conclusion: High recurrence and reoperative rates were observed in our centre. While the routine prophylactic LND remains controversial, high risk patients may be considered for prophylactic LND. The long-term risk and benefit of prophylactic LND with individualised patient selection in the local setting deserve further studies.

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伴有淋巴结转移的甲状腺癌颈部淋巴结清扫的结果:东南亚3年的经验。
在许多中心,治疗性淋巴结清扫仍然是治疗淋巴结转移患者的主要方法。然而,当地关于治疗性LND结果的数据仍然有限。因此,本研究旨在通过介绍LND治疗甲状腺癌患者的结果和我们在三级转诊中心的经验,为实践提供信息。方法:这是一项在马来西亚三级内分泌外科转诊中心进行的单中心回顾性观察研究。纳入2013年至2015年期间接受甲状腺全切除术并淋巴结清扫的患者,并回顾了3年随访期间的电子病历。比较不同淋巴结清扫(LND)的结果,包括中央颈清扫、侧颈清扫或两者兼而有之。结果:在纳入的43例受试者中,28例(65.1%)为IV期癌症。在纳入的43例受试者中,8例为中央淋巴结清扫,15例为外侧淋巴结清扫,其余20例为外侧和中央淋巴结清扫。16例(37.2%)患者出现局部复发,中央(2/8)、外侧(7/15)和两侧(7/20)之间无统计学差异。术后低钙7例(16.3%),声带麻痹5例(11.6%),需再手术9例(20.9%)。4名患者死亡结论:本院肿瘤复发率和再手术率高。虽然常规预防性LND仍有争议,但高风险患者可考虑预防性LND。在当地进行个体化患者选择的预防性LND的长期风险和益处值得进一步研究。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
期刊最新文献
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