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Determining the extent of lateral neck dissection necessary to establish regional disease control and avoid reoperation after previous total thyroidectomy and radioactive iodine for papillary thyroid cancer.
Head Neck. 2012 Oct; 34(10):1418-21.HN

Abstract

BACKGROUND

The purpose of this study was to evaluate patients who underwent lateral neck dissection for fine-needle aspiration (FNA)-confirmed disease after total thyroidectomy and radioactive iodine (RAI) to determine the appropriate extent of resection necessary to avoid reoperation.

METHODS

This study was conducted with a retrospective review of medical charts of 100 consecutive patients.

RESULTS

Seventy-seven percent of initial lateral neck dissection specimens and 64% of reoperative lateral neck dissection specimens had more than 1 nodal level of involvement. The sensitivity and negative predictive value of preoperative ultrasound to determine whether a specific nodal level was involved were: level 2: 54% and 66.2%; level 3: 47% and 49.4%; level 4: 60% and 55.4%; and level 5: 42% and 88.5%, respectively.

CONCLUSION

Patients undergoing lateral neck dissection after previous total thyroidectomy and RAI tend to have multiple involved nodes within multiple neck levels. Preoperative ultrasound is not sensitive enough to account for all of these involved nodes, therefore, a compartmental lateral neck dissection is recommended to minimize the risk of persistence and reoperation.

Authors+Show Affiliations

Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

22052539

Citation

Wu, Gaosong, et al. "Determining the Extent of Lateral Neck Dissection Necessary to Establish Regional Disease Control and Avoid Reoperation After Previous Total Thyroidectomy and Radioactive Iodine for Papillary Thyroid Cancer." Head & Neck, vol. 34, no. 10, 2012, pp. 1418-21.
Wu G, Fraser S, Pai SI, et al. Determining the extent of lateral neck dissection necessary to establish regional disease control and avoid reoperation after previous total thyroidectomy and radioactive iodine for papillary thyroid cancer. Head Neck. 2012;34(10):1418-21.
Wu, G., Fraser, S., Pai, S. I., Farrag, T. Y., Ladenson, P. W., & Tufano, R. P. (2012). Determining the extent of lateral neck dissection necessary to establish regional disease control and avoid reoperation after previous total thyroidectomy and radioactive iodine for papillary thyroid cancer. Head & Neck, 34(10), 1418-21. https://doi.org/10.1002/hed.21937
Wu G, et al. Determining the Extent of Lateral Neck Dissection Necessary to Establish Regional Disease Control and Avoid Reoperation After Previous Total Thyroidectomy and Radioactive Iodine for Papillary Thyroid Cancer. Head Neck. 2012;34(10):1418-21. PubMed PMID: 22052539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determining the extent of lateral neck dissection necessary to establish regional disease control and avoid reoperation after previous total thyroidectomy and radioactive iodine for papillary thyroid cancer. AU - Wu,Gaosong, AU - Fraser,Shannon, AU - Pai,Sara I, AU - Farrag,Tarik Y, AU - Ladenson,Paul W, AU - Tufano,Ralph P, Y1 - 2011/11/03/ PY - 2011/08/03/accepted PY - 2011/11/5/entrez PY - 2011/11/5/pubmed PY - 2013/3/8/medline SP - 1418 EP - 21 JF - Head & neck JO - Head Neck VL - 34 IS - 10 N2 - BACKGROUND: The purpose of this study was to evaluate patients who underwent lateral neck dissection for fine-needle aspiration (FNA)-confirmed disease after total thyroidectomy and radioactive iodine (RAI) to determine the appropriate extent of resection necessary to avoid reoperation. METHODS: This study was conducted with a retrospective review of medical charts of 100 consecutive patients. RESULTS: Seventy-seven percent of initial lateral neck dissection specimens and 64% of reoperative lateral neck dissection specimens had more than 1 nodal level of involvement. The sensitivity and negative predictive value of preoperative ultrasound to determine whether a specific nodal level was involved were: level 2: 54% and 66.2%; level 3: 47% and 49.4%; level 4: 60% and 55.4%; and level 5: 42% and 88.5%, respectively. CONCLUSION: Patients undergoing lateral neck dissection after previous total thyroidectomy and RAI tend to have multiple involved nodes within multiple neck levels. Preoperative ultrasound is not sensitive enough to account for all of these involved nodes, therefore, a compartmental lateral neck dissection is recommended to minimize the risk of persistence and reoperation. SN - 1097-0347 UR - https://www.unboundmedicine.com/medline/citation/22052539/Determining_the_extent_of_lateral_neck_dissection_necessary_to_establish_regional_disease_control_and_avoid_reoperation_after_previous_total_thyroidectomy_and_radioactive_iodine_for_papillary_thyroid_cancer_ L2 - https://doi.org/10.1002/hed.21937 DB - PRIME DP - Unbound Medicine ER -