Intraoperative pathologic evaluation of central compartment lymph nodes in patients undergoing lobectomy for unilateral papillary thyroid carcinoma

被引:2
作者
Bae, Hye Lim [1 ,2 ]
Ahn, Jong-hyuk [3 ,4 ]
Kwak, Junghak [2 ]
Kim, Hyun Soo [2 ,5 ]
Yoon, Sang Gab [2 ,6 ]
Yi, Jin Wook [2 ,4 ]
Kim, Su-jin [1 ,2 ,7 ]
Lee, Kyu Eun [1 ,2 ,7 ,8 ,9 ,10 ,11 ]
机构
[1] Seoul Natl Univ Hosp, Dept Surg, Seoul, South Korea
[2] Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea
[3] Chungbuk Natl Univ Hosp, Dept Surg, Chungbuk, South Korea
[4] Inha Univ, Dept Surg, Coll Med, Incheon, South Korea
[5] Seoul Natl Univ, Seoul Surg Clin, Seoul, South Korea
[6] Young Do Hosp, Dept Surg, Busan, South Korea
[7] Seoul Natl Univ, Coll Med, Canc Res Inst, Seoul, South Korea
[8] Seoul Natl Univ, Integrated Major Innovat Med Sci, Grad Sch, Seoul, South Korea
[9] Seoul Natl Univ Hosp, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
[10] Seoul Natl Univ, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
[11] Inha Univ Hosp, Dept Surg, Incheon, South Korea
关键词
FROZEN-SECTION EXAMINATION; CENTRAL NECK DISSECTION; EXTRATHYROIDAL EXTENSION; CANCER; RECURRENCE; METASTASIS; SURVIVAL; RISK; WELL; PREDICTION;
D O I
10.1016/j.asjsur.2023.08.203
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background/Objective: Although papillary thyroid carcinoma (PTC) has an excellent prognosis, it can cause central lymph node metastasis (CLNM) which can increase local recurrence. Intraoperative pathologic evaluation (IOPE) can provide evidence regarding CLNM and help surgeons determine the appropriate surgical approach. The aim of this study was to evaluate the efficacy of IOPE and to determine risk factors associated with CLNM in unilateral PTC without preoperative clinical evidence of CLNM. Methods: Medical charts of 227 patients who had unilateral PTC without clinical lymph node metastasis preoperatively were reviewed retrospectively. They were scheduled for thyroid lobectomy and prophylactic central lymphadenectomy (CND) from January 1, 2017 to December 31, 2017. Results: Total follow-up period was 47.6 +/- 10.6 months. CLNM was identified in 57 (25.1%) patients during IOPE and in 72 (31.7%) patients during final pathological analysis. The sensitivity and specificity of IOPE were 76.4% and 98.7%, respectively. IOPE through central lymph node dissection was safely performed with low complications (vocal cord palsy, 5.7%; hypoparathyroidism, 22.8%). Age < 55 years, echogenic foci on preoperative ultrasonography, and extrathyroidal extension at final pathological report were significantly associated with an increased risk of CLNM (p 1/4 0.006, p < 0.001, and p < 0.001, respectively). In terms of oncological outcomes, there was no significant difference between the true negative and false negative results in IOPE. Conclusion: IOPE can safely provide accurate information for determining disease status and surgical extent. Further long-term studies are needed to evaluate clinical benefits of IOPE. (c) 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:360 / 366
页数:7
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