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Central neck dissection

Marco Siano, Salvatore Alfieri, Roberta Granata, Giuseppina Calareso, Ester Orlandi, Cristiana Bergamini, Laura Deborah Locati
PURPOSE: Two tyrosine kinase inhibitors (TKIs), vandetanib and cabozantinib, have been approved for recurrent/metastatic (R/M) medullary thyroid carcinoma (MTC). To date, it is still debated when and which TKI has to be started in R/M MTC patients. This is due to 1) TKI-related toxicity burden, 2) no overall survival benefit for either TKI, and 3) progression-free survival improvement in MTC subgroups ( RETM918T and RAS mutations) treated with cabozantinib. Herein, we present a case of R/M MTC with a discordant disease behavior because of spontaneous regression of some parenchymal sites along with progression of bone metastases, putting into the question the best timing for starting TKIs in R/M MTC...
February 19, 2019: Tumori
Bo Wang, Yu-Jing Weng, Si-Si Wang, Wen-Xin Zhao, Shou-Yi Yan, Li-Yong Zhang, Jia Wen
BACKGROUND: Endoscopic thyroidectomy is popular among patients with cosmetic requirements. However, when lateral neck dissection (LND) is required, endoscopic surgery may be challenging. Therefore, we introduced needle-assisted endoscopic technique to achieve endoscopic LND procedure and evaluated its safety and feasibility in the present study. METHODS: Medical records of 37 patients who underwent needle-assisted endoscopic thyroidectomy with LND were retrospectively reviewed...
February 18, 2019: Head & Neck
Mehmet Eser Sancaktar, Gülser Saylam, Bülent Öcal, Ahmet Uluat, Ömer Bayır, Erman Çakal, Mehmet Hakan Korkmaz
Backround/aim: Papillary thyroid carcinomas (PTC) frequently metastasize to regional lymph nodes. Our purpose was to investigate the predictive role of tumor location for lymph node metastasis pattern in PTCs. Materials and methods: Medical records of 110 PTC patients were reviewed retrospectively. Tumor location was determined as upper, middle, and lower pole according to ultrasonography (USG) findings. The effects of age, sex, tumor size, and location on lymph node metastasis were investigated...
February 11, 2019: Turkish Journal of Medical Sciences
Hong Kyu Kim, Dawon Park, Hoon Yub Kim
BACKGROUND: Transoral approach for thyroidectomy draws attention recently among the thyroid surgeons, with the merits of cosmetic outcomes and minimal flap dissection. The aim of this study is to demonstrate the details and the steps of transoral robotic thyroidectomy. METHODS: We made three incisions in the gingival-buccal sulcus for three 8-mm intraoral ports: one inverted U-shaped 1-cm midline incision approximately 2 cm above the frenulum, and two 0.5-cm lateral incisions near the commissure of lips...
February 13, 2019: Head & Neck
Oreste Iocca, Alessio Farcomeni, Armando De Virgilio, Pasquale Di Maio, Paweł Golusinski, Luca Malvezzi, Raul Pellini, Wojciech Golusinski, Christopher H Rassekh, Giuseppe Spriano
Background: Lymph node involvement is a fundamental prognostic factor in head and neck squamous cell carcinoma (SCC). Lymph node yield (LNY), which is the number of lymph nodes retrieved after neck dissection, and lymph node ratio (LNR), which is the ratio of positive lymph nodes out of the total removed, are measurable indicators that may have the potential to be used as prognostic factors. The present study is designed to define the exact role of LNY and LNR regarding the overall and specific survival of patients affected by oral cavity and oropharyngeal SCC...
June 2019: Contemporary Clinical Trials Communications
Yunjun Wang, Qing Guan, Jun Xiang
Objective: Extensive lateral neck dissection (LND), especially routine level V dissection, may potentially increase morbidity and have no significant benefit to survival in patients with papillary thyroid carcinoma (PTC). Our study aimed to determine the pattern and risk factors for level V lymph node metastasis (LNM) and to develop an assessment model based on a nomogram for predicting whether level V dissection is necessary. Methods: A total of 1037 PTC patients with clinically suspected LNM (N1b) who underwent total thyroidectomy (TT) with central LND and unilateral LND from 2011 to 2015 were retrospectively retrieved...
2019: Journal of Cancer
Ahmad M Eltelety, David J Terris
The incidence of thyroid cancer is increasing, largely attributable to overdetection related to prevalent diagnostic and radiologic imaging modalities. Papillary thyroid cancer remains the most common thyroid malignancy. It has a high tendency for regional metastasis to the cervical lymph nodes. The optimal management of the neck in patients with thyroid carcinoma has long been an important topic of debate. This article addresses central and lateral neck dissection, providing a simplified guide to the most up-to-date and evidence-based practices...
March 2019: Endocrinology and Metabolism Clinics of North America
Y C Qian, F Z Liu, W P Yao, Y B Zhao, Y Jiang, Y Zhang
Objective: To evaluate the effects of staining with carbon nanoparticles on the identification of parathyroid glands and lymph nodes during thyroid carcinoma surgery combined with lymphadenectomy. Methods: A total of 194 patients with papillary thyroid carcinoma who underwent thyroidectomy combined with lymphadenectomy from April 2016 to January 2018 were reviewed. Of them 104 cases were injected with carbon nanoparticles in operation area (nanocarbon group) and other 90 cases without the injection of carbon nanoparticles were as control group...
January 7, 2019: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Marco Puccini, Gianpiero Manca, Carlo Maria Neri, Giuseppe Boni, Virginia Coli, Ludovico Maria Garau, Patrick M Colletti, Domenico Rubello, Piero Buccianti
PURPOSE: BRAF V600E mutation papillary thyroid cancer (PTC) is more aggressive with a higher risk of lymph node involvement and a poorer prognosis. Prior studies failed to demonstrate the superiority of prophylactic lymphadenectomy. We investigated the utility of additional radio-guided sentinel node biopsy (SNB). METHODS: We analyzed 15 patients with N0 PTC by ultrasound and BRAF mutation on preoperative biopsy treated with total thyroidectomy (TT) or TT + prophylactic central neck dissection (PCND) alone or with SNB...
January 25, 2019: Clinical Nuclear Medicine
Lan Wei, Lin Bai, Lina Zhao, Tianyu Yu, Qingjie Ma, Bin Ji
OBJECTIVE: One of the presumed advantages of prophylactic central neck dissection (pCND) is offering staging basis for more aggressive radioactive iodine (RAI) therapy, which postulates the necessity of high dose for treatment efficacy. The present study aims to compare the effectiveness between low-dose and high-dose RAI in a select cohort of cN0 papillary thyroid cancer (PTC) patients with pathological N1a (pN1a) disease revealed by pCND in terms of ablation rate and response to therapy...
January 25, 2019: World Journal of Surgery
Roberto Cirocchi, Alberto Arezzo, Vito D'Andrea, Iosief Abraha, Georgi I Popivanov, Nicola Avenia, Chiara Gerardi, Brandon Michael Henry, Justus Randolph, Marcin Barczyñski
BACKGROUND: Injuries to the recurrent inferior laryngeal nerve (RILN) remain one of the major post-operative complications after thyroid and parathyroid surgery. Damage to this nerve can result in a temporary or permanent palsy, which is associated with vocal cord paresis or paralysis. Visual identification of the RILN is a common procedure to prevent nerve injury during thyroid and parathyroid surgery. Recently, intraoperative neuromonitoring (IONM) has been introduced in order to facilitate the localisation of the nerves and to prevent their injury during surgery...
January 19, 2019: Cochrane Database of Systematic Reviews
Myunghee Kang, Na Rae Kim, Dong Hae Chung, Jae Yeon Seok, Dong Young Kim
Necrobiotic xanthogranulomatous reaction is a multiorgan, non-Langerhans cell histiocytosis with an unknown etiology. Occurrence in the salivary gland is extremely rare. We recently identified a case of necrobiotic xanthogranulomatous sialadenitis in a 73-year-old Korean woman who presented with a painless palpable lesion in the chin. There was no accompanying cutaneous lesion. Partial resection and subsequent wide excision with neck dissection were performed. Pathologically, examination showed a severe inflammatory lesion that included foamy macrophages centrally admixed with neutrophils, eosinophils, lymphocytes, plasma cells, and scattered giant cells, as well as necrobiosis...
January 16, 2019: Journal of Pathology and Translational Medicine
Jian-Biao Wang, Ya-Yu Sun, Liu-Hong Shi, Lei Xie
The benefits of prophylactic central neck dissection (pCND) for treating patients with clinical node-negative (cN0) papillary thyroid carcinoma (PTC) remain controversial. Lymph node metastases have been strongly associated with local recurrence and low survival, especially in PTC patients with 5 or more or ≥2 mm metastatic lymph nodes. The following study investigates the incidence and risk factors of more than 5 or ≥2 mm metastatic lymph nodes in the central compartment.A total of 611 patients with cN0 PTC were retrospectively analyzed...
January 2019: Medicine (Baltimore)
Ke Si Zheng, Yong Zeng, Cong Chen, Yuan Zhao Wu, Bi Chen, Wen Bing Ying, Ke Wen Zheng
Objective To explored the risk factors of lymph node metastasis in papillary thyroid microcarcinoma (PTMC) by analyzing the data from the Surveillance,Epidemiology and End Results (SEER) database.Methods The data of 31 017 patients with PTMC in the SEER database from 2002 to 2012 were retrospectively analyzed. Logistic and Cox regression analyses were used to explore the associations of the factors and the risk of lymph node metastasis in PTMC.Results Multivariate analysis revealed that male (OR=0.673,95%CI=0...
December 20, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Safi Dokmak, Béatrice Aussilhou, Yacine BenSafta, Fadhel Samir Ftériche, Olivier Soubrane, Alain Sauvanet
BACKGROUND: Gastric traction is essential in laparoscopic distal pancreatic resections. We already described the single gastric hanging providing good exposure on the left pancreas and we herein introduce a modification named the double gastric hanging. METHODS: The double gastric hanging in which 2 surgical tapes encircle the body and antrum of the stomach is indicated in patients who requiring pancreatic neck resection, dissection along the celiac trunk collaterals and lymph nodes, the duodenal wall, and the gastroduodenal artery...
January 2, 2019: Digestive Surgery
Vishal M Bulsara, Helen V Worthington, Anne-Marie Glenny, Janet E Clarkson, David I Conway, Michaelina Macluskey
BACKGROUND: Surgery is an important part of the management of oral cavity cancer with regard to both the removal of the primary tumour and removal of lymph nodes in the neck. Surgery is less frequently used in oropharyngeal cancer. Surgery alone may be treatment for early-stage disease or surgery may be used in combination with radiotherapy, chemotherapy and immunotherapy/biotherapy. There is variation in the recommended timing and extent of surgery in the overall treatment regimens of people with these cancers...
December 24, 2018: Cochrane Database of Systematic Reviews
Young Jae Ryu, Shin Jae Kang, Jin Seong Cho, Jung Han Yoon, Min Ho Park
There is still debate regarding the role of routine central lymph node (LN) dissection in treating clinically node-negative papillary thyroid cancer (PTC). The aim of this study was to investigate the risk factors for lateral recurrence after total thyroidectomy and prophylactic bilateral central LN dissection in clinically node-negative PTC patients.We retrospectively collected the medical records of 1406 PTC patients who underwent total thyroidectomy and prophylactic bilateral central LN dissection between January 2004 and December 2008...
December 2018: Medicine (Baltimore)
Benjamin van der Woerd, Krupal B Patel, Anthony C Nichols, Kevin Fung, John Yoo, S Danielle MacNeil
OBJECTIVES: Organ preserving surgery (OPS) and radiotherapy (RT) are both accepted treatment options for early stage supraglottic cancer (SGC). Radiation has supplanted surgery in most cases, because of the perception that surgery results in poorer functional outcomes. However, evidence suggests that OPS with a neck dissection may be associated with improved survival. Our objective was to conduct a systematic review of the literature to compare functional outcomes of OPS and RT for early SGC...
December 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
L S Jin
Objective: To study the features of cervical lymph node metastasis and the optimal type of surgical treatment for untreated medullary thyroid carcinoma. Method: To retrospectively analyze the clinical data of 45 patients with untreated medullary thyroid carcinoma who received surgical treatment in our hospital. The patterns of cervical lymph node metastasis and the surgical treatment were investigated. Result: 34(75.6%) cases were confirmed with lymph node metastasis. Among them,18(40.0%) cases were confirmed with central lymph node metastasis; 30(66...
October 5, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
F Y Liang, P Han, Q Cai, R H Chen, S T Yu, M R Luo, X M Huang
Objective: To evaluate the feasibility, effectiveness and safety of robot-assisted transaxillary thyroidectomy (RATT). Method: The clinical data of 66 patients undergoing RATT from November 2016 to May 2018 were prospectively collected and analyzed. The average age was (38.61±11.72) years, 57 cases were female and 9 cases were male. Preoperative fine needle aspiration biopsy revealed papillary thyroid carcinoma in 58 cases and follicular thyroid tumor in 8 cases. Result: All the patients successfully completed RATT, and there was no open operation, in which 54 cases of ipsilateral lobetomy and isthmus resection and ipsilateral central lymph node dissection, 8 cases with ipsilateral lobectomy and contralateral near-total lobectomy, and total thyroidectomy with ipsilateral central lymph node dissection and selective neck dissection combined with retroauricular approach in 4 cases...
July 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
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