Prevalence of level IIb involvement in patients undergoing lateral neck dissection for papillary thyroid cancer

Presentation: C156
Topic: Thyroid Cancer
Type: Poster
Date: Thursday, April 19, 2018
Session: 9:00 AM - 7:00 PM
Authors: Luis A De Jesus Sanchez1, Aisnley C Mann2, James K Hawley3, Mark E Zafareo, MD4, Erich M Sturgis, MD, MPH4
Institution(s): 1School of medicine, Medical Science Campus, University of Puerto Rico, San Juan, Puerto Rico, 2College of Science, Louisiana State University, Baton Rouge, Louisiana, USA, 3College of Liberal Arts, The University of Texas, Austin, Texas, USA, 4Department of head and neck surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

While papillary thyroid cancer does metastasize to level IIb of the neck, this is a rare occurrence and dissection of level IIb can result in significant shoulder morbidity.  Our goal was to document the involvement of level IIb lymph nodes in PTC patients undergoing a lateral neck dissection by two a neck surgeon at a large tertiary referral cancer center. We reviewed the medical records of all patients with pathologically confirmed PTC who underwent therapeutic lateral neck dissections by EMS from June, 2003- July,2017. Level IIa and IIb were sent separately to pathology and reported individually. The involvement of level IIa, IIb, III and IV were respectively 59%, 5%, 80% and 74%. Six out of the eight cases with level IIb metastasis had the presence of metastasis in level IIa. In this retrospective patient review we concur with the current guidelines for cervical lymph node dissection in PTC patients. Level IIb should be excised only when there is clinical, radiological or intraoperative findings that indicate disease at this level. Thus diminishing possible morbidity in patients.

Keywords:

Papillary Thyroid Cancer
Lateral neck dissection
Level IIb cervical lymph node