Volume 35, Issue 10 pp. 1439-1442
Original Article

Metastatic papillary thyroid cancer with lateral neck disease: Pattern of spread by level

Mazin Merdad MD, MPH

Corresponding Author

Mazin Merdad MD, MPH

Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

Department of Otolaryngology—Head & Neck Surgery, University of Toronto, 190 Elizabeth Street, Room 3S438, Toronto Ontario, Canada, M5G 2N9. E-mail: [email protected]Search for more papers by this author
Antoine Eskander MD

Antoine Eskander MD

Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

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Teresa Kroeker MD

Teresa Kroeker MD

Department of Otolaryngology—Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

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Jeremy L. Freeman MD

Jeremy L. Freeman MD

Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

Department of Otolaryngology—Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

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First published: 10 September 2012
Citations: 17

This article was published online on 10 September 2012. An error was subsequently identified. This notice is included in the online and print versions to indicate that both have been corrected 8 August 2013.

Abstract

Background

Currently, there is no clear consensus on the extent of this lateral neck dissection required in papillary thyroid cancer (PTC) with lateral neck metastasis. The purpose of this study was to review our experience with metastatic PTC, and identify the pattern of lymphatic spread to the lateral neck.

Methods

A retrospective medical chart review of PTC patients treated with lateral neck dissection (levels II–Vb) at our institution between January 2004 and 2011. A total of 185 patients underwent 248 selective lateral neck dissections.

Results

Levels II, III, IV, and Vb were respectively involved in 49.3%, 76.6%, 61.6%, and 29.2% of cases.

Conclusion

We advocate for a routine excision of levels II, III, IV, and Vb in PTC with metastasize to any lateral neck level. Although we have routinely dissected level IIb, it may be appropriate to omit its dissection, as well as level Va, when there are no clinical, radiologic, or intraoperative evidence of disease involving these sublevels. © 2012 Wiley Periodicals, Inc. Head Neck 35: 1439–1442, 2013

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