■甲状腺乳头状癌(PTC)的单侧或双侧预防性中央颈清扫术(CND)仍存在争议。我们旨在评估对侧气管旁淋巴结转移的危险因素以及CND是否可以单侧进行。
■前瞻性地收集了因PTC伴外侧转移而接受双侧CND和外侧颈清扫术(LND)伴甲状腺切除术的患者的数据,在2012年1月至2019年11月期间进行了回顾性评估.根据对侧气管旁区域是否存在转移(第1组)和不存在转移(第2组),将患者分为两组。共有42例患者(46±15.7年)进行了手术。在对侧气管旁区域,第1组(35.7%)有转移,而第2组(64.3%)无转移。在第1组和第2组中,转移率分别为100%和77.8%(p=0.073),46.7%对18.5%(p=0.078),同侧气管的80%和40.7%(p=0.023),喉前和气管前淋巴结,分别。与第2组相比,第1组中央区转移淋巴结的数量显着增加;10.7±8.4vs.双侧中央区材料2.6±2.4(p=0.001);8.3±7.4vs.同侧单侧中央区域的侧转移2.9±2.7(p=0.001);3.8±3.4vs.同侧气管旁面积1.9±1.9(p=0.023);3.7±4.6vs.气管前区域为0.6±0.9(p=0.001),分别。然而,关于喉前区域材料没有发现显着差异(0.9±1.8vs.0.2±0.4(p=0.71))。
■>单侧CND材料中的2个转移性中央淋巴结(AUC:0.814,p<0.001,J=0.563)可以93%的灵敏度估计对侧气管旁转移,63%的特异性,而>2个气管前转移淋巴结(AUC:0.795,p<0.001,J:0.563)可以估计对侧气管旁转移,敏感性为60%,特异性为96.3%。
■在有侧方转移的患者中,同侧气管旁转移率为85%,对侧气管旁转移率为35.7%。同侧中央区或气管前淋巴结转移的数量可能有助于预测对侧气管旁淋巴结转移。值得注意的是,单侧CND可在同侧中央区存在≤2个转移灶的情况下进行.
UNASSIGNED: Unilateral or bilateral prophylactic central neck dissection (CND) in papillary thyroid cancer (PTC) is still controversial. We aimed to evaluate the risk factors for contralateral paratracheal lymph node metastasis and whether CND might be performed unilaterally.
UNASSIGNED: Prospectively collected data of patients who underwent bilateral CND and lateral neck dissection (LND) with thyroidectomy due to PTC with lateral metastases, between January 2012 and November 2019, were evaluated retrospectively. The patients were divided into two groups according to the presence (Group 1) and absence (Group 2) of metastasis in the contralateral paratracheal region.A total of 42 patients (46 ±15.7 years) were operated. In the contralateral paratracheal region, Group 1 (35.7%) had metastases, while Group 2 (64.3%) had no metastases. In groups 1 and 2, metastasis rates were 100% vs 77.8% (p=0.073), 46.7% vs 18.5% (p=0.078), and 80% vs 40.7% (p=0.023) for the ipsilateralparatracheal, prelaryngeal and pretracheal lymph nodes, respectively.The number of metastatic lymph nodes in the central region was significantly higher in Group 1 compared to Group 2 as; 10.7±8.4 vs. 2.6±2.4 (p=0.001) in bilateral central region material; 8.3±7.4 vs. 2.9±2.7 (p=0.001) in lateral metastasis with ipsilateral unilateral central region; 3.8±3.4 vs. 1.9±1.9 (p=0.023) in ipsilateralparatracheal area; and 3.7±4.6 vs. 0.6±0.9 (p=0.001) in pretracheal region, respectively. However, no significant difference was found regarding the prelaryngeal region material (0.9±1.8 vs. 0.2±0.4 (p=0.71)).
UNASSIGNED: >2 metastatic central lymph nodes in unilateral CND material (AUC: 0.814, p<0.001, J=0.563) can estimate contralateral paratracheal metastasis with 93% sensitivity, 63% specificity, while >2 pretracheal metastatic lymph nodes (AUC: 0.795, p<0.001, J: 0.563) can estimate contralateral paratracheal metastasis with 60% sensitivity and 96.3% specificity.
UNASSIGNED: In patients with lateral metastases, the rate of ipsilateralparatracheal metastasis is 85%, while the rate of contralateral paratracheal metastasis is 35.7%. The number of ipsilateral central region or pretracheal lymph node metastases may be helpful in predicting contralateral paratracheal lymph node metastases. Notably, unilateral CND may be performed in the presence of ≤ 2 metastases in the ipsilateral central region.