A Study on Nodal Positivity in Central Compartment of Neck in Differentiated Thyroid Malignancies: A Study From Tertiary Care Center
Journal Title: International Journal of Contemporary Medical Research - Year 2016, Vol 3, Issue 1
Abstract
Introduction: Thyroid malignancies are the difficult one to treat. The present study was designed to study the incidence of occult nodal metastases, total nodal yield and percentage of nodal positivity in central compartment in clinically node negative patients. 2. Association between primary tumor and nodal positivity. Materials and methods: We recruited 50 patients with Differentiated Thyroid Cancers with clinically and radiologically negative nodes admitted to surgical wards in The Department of General Surgery and Surgical Oncology, during the study period from August 2013 to February 2015. CND and DTC protocol necessary for thyroidectomy were followed. Total thyroidectomy plus CND was performed in all cases by the same surgeon. Node clearance was performed in the anatomic space bounded by the hyoid bone cephalad and the suprasternal notch caudad and from the carotid sheath on one side to that on the other side laterally. Data of Nodes obtained at operation; Number of metastatic nodes found during operation was recorded. The samples were sent to the same pathologist for histopathological report. CND results were reported as per protocol: (1) Histopathological diagnosis (2) Size of primary tumor (3) Total nodal yield (4) Number of positive nodes (5) Extra thyroid extension. The MACIS scorewas calculated for all cases, and patients were assigned to the low-risk (<6 points) or high-risk (>6 points) MACIS groups.50 patients were studied. Results: Meanage was 43.70 ± 13.461, minimum age 21 and maximum age 68. All nodal positive cases were papillary type; none of the follicular carcinomas had central lymph node metastasis. 6 cases with tumor size >2 cm had positive central compartment nodes and 1 patent with tumor size < 2 cm had positive central compartment nodes. No patient had MACIS SCORE > 6, which infers that all cases were low risk group. Conclusion: Mean age was 43.70 ± 13.461. Papillary carcinoma is the most common type of DTC. Females have a preponderance over males (Female:Male = 2.8: 1). Tumour size >2 cm was independent risk factor for Central lymph node metastasis. Tumour size was frequently more in males.
Authors and Affiliations
Laxmana Sastry, Hemanth Kumar, Rahul .
Keywords
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