Auris, nasus, larynx · 2018
The impact of the number of harvested central lymph nodes on the lymph node ratio.
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Chung Eun-Jae, Cho Sung-Jin, Park Min-Woo, Rho Young-Soo
Аннотация
OBJECTIVE: The purpose of this study was to analyze the impact of lymph node harvest on the lymph node ratio (LNR).
METHODS: We retrospectively reviewed 106 patients diagnosed preoperatively with PTMC (papillary thyroid microcarcinoma), no evidence of central or lateral neck nodal metastasis, and who underwent a total thyroidectomy and bilateral central lymph node neck dissection (CND).
RESULTS: The median number of retrieved lymph nodes in the central compartments was 7±6.59 (range: 1-42). The mean number of metastatic lymph nodes in the central compartments on pathology was 1.1±1.79 (range: 0-7). The high node volume group (>7) had a significantly higher rate of central lymph node (CLN) metastasis than the low node volume group (≤7) in the final pathologic report (p<0.001). With the linear regression method, the number of CLN metastasis increased as the number of retrieved lymph nodes increased (correlation coefficient=0.286, p=0.003). The multivariate analysis confirmed the number of retrieved lymph nodes in the central compartments was a risk factor for high LNR (p=0.008, odds ratio 3.737). The rates of vocal fold palsy and hypoparathyroidism did not differ according to the number of retrieved lymph nodes.
CONCLUSION: The lymph node ratio in the final pathologic report is larger when a greater number of lymph nodes are retrieved during the central compartment neck dissection.
METHODS: We retrospectively reviewed 106 patients diagnosed preoperatively with PTMC (papillary thyroid microcarcinoma), no evidence of central or lateral neck nodal metastasis, and who underwent a total thyroidectomy and bilateral central lymph node neck dissection (CND).
RESULTS: The median number of retrieved lymph nodes in the central compartments was 7±6.59 (range: 1-42). The mean number of metastatic lymph nodes in the central compartments on pathology was 1.1±1.79 (range: 0-7). The high node volume group (>7) had a significantly higher rate of central lymph node (CLN) metastasis than the low node volume group (≤7) in the final pathologic report (p<0.001). With the linear regression method, the number of CLN metastasis increased as the number of retrieved lymph nodes increased (correlation coefficient=0.286, p=0.003). The multivariate analysis confirmed the number of retrieved lymph nodes in the central compartments was a risk factor for high LNR (p=0.008, odds ratio 3.737). The rates of vocal fold palsy and hypoparathyroidism did not differ according to the number of retrieved lymph nodes.
CONCLUSION: The lymph node ratio in the final pathologic report is larger when a greater number of lymph nodes are retrieved during the central compartment neck dissection.