Journal articles: 'Lateral lymph node dissection'

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Wu, Xin, Binglu Li, Chaoji Zheng, Wei Liu, Tao Hong, and Xiaodong He. "Risk Factors for Lateral Lymph Node Metastases in Patients With Sporadic Medullary Thyroid Carcinoma." Technology in Cancer Research & Treatment 19 (January 1, 2020): 153303382096208. http://dx.doi.org/10.1177/1533033820962089.

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Purpose: Medullary thyroid carcinoma is a rare endocrine malignancy; 75% of patients with this disease have sporadic medullary thyroid carcinoma. While surgery is the only curative treatment, the benefit of prophylactic lateral neck dissection is unclear. This study aimed to analyze the clinicopathological risk factors associated with lateral lymph node metastases and determine the indication for prophylactic lateral neck dissection in patients with sporadic medullary thyroid carcinoma. Methods: The medical records of patients with medullary thyroid carcinoma who were treated at our hospital between January 2002 and January 2020 were retrospectively reviewed; a database of their demographic characteristics, test results, and pathological information was constructed. The relationship between lateral lymph node metastases and clinicopathologic sporadic medullary thyroid carcinoma features were analyzed using univariate and multivariate analyses. Results: Overall, 125 patients with sporadic medullary thyroid carcinoma were included; 47.2% and 39.2% had confirmed central and lateral lymph node metastases, respectively. Univariate and multivariate analyses identified 2 independent factors associated with lateral lymph node metastases: positive central lymph node metastases (odds ratio = 9.764, 95% confidence interval: 2.610–36.523; p = 0.001) and positive lateral lymph nodes on ultrasonography (odds ratio = 101.747, 95% confidence interval: 14.666–705.869; p < 0.001). Conclusion: Medullary thyroid carcinoma is a rare endocrine malignancy. Lymph node metastases are common in patients with sporadic medullary thyroid carcinoma. Prophylactic lateral neck dissection is recommended for patients who exhibit positive central lymph node metastases and/or positive lateral lymph nodes on ultrasonography.

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Ozawa, Heita, Hiroki Nakanishi, Junichi Sakamoto, Yoshiyuki Suzuki, and Shin Fujita. "Prognostic impact of the number of lateral pelvic lymph node metastases on rectal cancer." Japanese Journal of Clinical Oncology 50, no. 11 (July 20, 2020): 1254–60. http://dx.doi.org/10.1093/jjco/hyaa122.

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Abstract Background This study aimed to clarify the number of lateral pelvic lymph node metastases of colorectal cancer for which prognosis could be improved by dissection. Methods We analysed the data of 30 patients with lateral pelvic lymph node metastases of rectal cancer that underwent a total mesorectal excision with lateral pelvic lymph node dissection at our institute from 1986 to 2016. We performed survival analysis on the number of lateral pelvic lymph node metastases in each of these patients and identified an optimal cut-off point of the number of lateral pelvic lymph node metastases that would predict recurrence-free survival using the receiver operating characteristic curves and an Akaike information criterion value. Results The 5-year recurrence-free survival and overall survival of patients with one or two lateral pelvic lymph node metastases were significantly better than that of those with three or more (5-year recurrence-free survival, 63.3 vs. 0.0%, respectively; hazard ratio, 0.23; 95% CI, 0.07–0.72; P = 0.0124) (5-year overall survival, 68.2 vs. 15.6%, respectively; hazard ratio, 0.29; 95% CI, 0.09–0.92; P = 0.0300). All of the metastatic lateral pelvic lymph nodes in the group with one or two lateral pelvic lymph node metastases were restricted to the internal iliac artery or obturator nerve regions. Conclusions The cut-off number of lateral pelvic lymph node metastases in the internal iliac artery or obturator nerve regions of colorectal cancer cases in whom prognosis was improved by lateral pelvic lymph node dissection was 2; patients who had <3 lateral pelvic lymph node metastases had better prognoses than those with ≥3 lateral pelvic lymph node metastases.

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Morohashi, Hajime, Yoshiyuki Sakamoto, Takuya Miura, Daichi Ichinohe, Kotaro Umemura, Takanobu Akaishi, Kentaro Sato, et al. "Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type." International Journal of Colorectal Disease 36, no. 6 (February 1, 2021): 1251–61. http://dx.doi.org/10.1007/s00384-021-03870-5.

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Abstract Purpose There are no reports showing the significance and effective range of dissection for patients with lateral lymph node metastasis (LLNM). This study aimed to investigate the indications for lateral lymph node dissection (LLND) in patients with LLNM based on prognostic factors and recurrence types. Methods We reviewed 379 patients with advanced rectal cancer who were treated with total mesorectal excision plus LLND. We analyzed background factors and survival times of patients who had LLNM to determine prognostic factors and recurrence types. Results Pathological LLNM occurred in 44 (11.6%). Among patients with LLNM, the predictors of poor prognoses, according to univariate analysis, were > 3 node metastases, the presence of node metastasis on both sides, and spreading beyond the internal iliac lymph nodes. Moreover, LLNM beyond the internal iliac region was found to be an independent prognostic risk factor. Twenty-eight of the 44 patients with lateral lymph node metastasis (64%) relapsed, 22 of whom had distant metastases and 11 of whom experienced local recurrences. Among the latter group, nine (20%) and two (5%) had recurrences in the central and lateral pelvis, respectively. Conclusion The therapeutic benefit of resection was high, especially in patients with ≤ 3 positive lateral lymph nodes, one-sided bilateral lymph node areas, and positive nodes localized near the internal iliac artery.

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Chen, Yifan, Shuo Chen, Xiaoying Lin, Xiangqing Huang, Xiaofang Yu, and Juying Chen. "Clinical Analysis of Cervical Lymph Node Metastasis Risk Factors and the Feasibility of Prophylactic Central Lymph Node Dissection in Papillary Thyroid Carcinoma." International Journal of Endocrinology 2021 (January 31, 2021): 1–8. http://dx.doi.org/10.1155/2021/6635686.

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Objective. To identify the risk factors for cervical lymph node metastasis (CLNM) and the feasibility of prophylactic central lymph node dissection. Methods. The characteristics of 1107 patients were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with lymph node metastasis. The relationship between the central lymph node dissection (CLND) and lateral lymph node metastasis (LLNM) was analyzed using the correlation analysis. Results. The probability of CLNM was closely related to the male gender, age <55, and the increase of tumor size. Those patients with an increase in tumor size and CLNM were extremely prone to LLNM. Also, LLNM was more likely to happen in those with the more positive central lymph nodes. Routine prophylactic central lymph node dissection (P-CLND) did not increase the risk of complications. Conclusion. P-CLND should be considered as a reasonable surgical treatment for PTC.

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Ogura, Atsushi, Stefan van Oostendorp, and Miranda Kusters. "Neoadjuvant (chemo)radiotherapy and Lateral Node Dissection: Is It Mutually Exclusive?" Clinics in Colon and Rectal Surgery 33, no. 06 (September 22, 2020): 355–60. http://dx.doi.org/10.1055/s-0040-1714239.

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AbstractThe importance of total mesorectal excision (TME) has been the global standard of care in patients with rectal cancer. However, there is no universal strategy for lateral lymph nodes (LLN). The treatment of the lateral compartment remains controversial and has gone to the opposite directions between Eastern and Western countries in the past decades. In the East, mainly Japan, surgeons consider LLN metastases as regional disease and have performed TME with lateral lymph node dissection (LLND) without neoadjuvant (chemo)radiotherapy ([C]RT) in patients with clinical Stage II/III rectal cancer below the peritoneal reflection. In the West, neoadjuvant radiotherapy or has been the standard, and surgeons do not perform LLND assuming the (C)RT can sterilize most lateral lymph node metastasis (LLNM). Recent evidences show that lateral nodes are the major cause of local recurrence after (C)RT plus TME, and LLND reduces local recurrence particularly from the lateral compartment. Probably a combination of the two strategies, that is, neoadjuvant (C)RT plus LLND, would be needed to improve outcomes in patients with lateral nodal disease.

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Ubukata, Mamiko, Michio Itabashi, Shimpei Ogawa, Tomoichiro Hirosawa, Yoshiko Bamba, Sayumi Nakao, and Shingo Kameoka. "Japanese D3 lymph node dissection in low rectal cancer with inferior mesenteric lymph node and/or lateral lymph node metastases." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 530. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.530.

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530 Background: The current Japanese Classification of Colorectal Carcinoma defines inferior mesenteric lymph nodes (IMLN) and lateral lymph nodes (LLN) as regional lymph nodes in rectal cancer. It states that these lymph nodes should be dissected when performing D3 dissection for rectal cancer. However, there is currently no consensus on the significance of Japanese D3 lymph node dissection in low rectal cancer. A retrospective study involving a large number of patients was conducted. Methods: The subjects were 2,743 patients registered in the multi-institutional registry of the Japanese Society for Cancer of the Colon and Rectum. The data were analyzed for outcomes in R0 cases with IMLN and/or LLN metastasis (IMLN(+)LLN(-) or IMLN(-)LLN(+) or IMLN(+)LLN(+)). Results: In the control group, 67 patients (2.7%) were considered positive for IMLN metastasis, 181 patients (7.4%) for LLN metastasis, and 34 patients (1.4%) for IMLN + LLN metastasis. The outcomes in the R0 cases with IMLN and/or LLN metastasis were 52.8% for 5-year RFS and 63.1% for 5-year OS, which were each better than for R1+R2 cases (5-year RFS 26.2%, p<0.0001; 5-year OS 30.5%, p<0.0001). Including only those with a total of seven or more metastatic lymph nodes, the outcomes in the R0 cases with IMLN and/or LLN metastasis were 53.6% for 5-year RFS and 64.9% for 5-year OS, which did not differ significantly from those for IMLN(-)LLN(-) cases (5-year RFS 54.4%, 5-year OS 55.2%) (RFS: p=0.9718, OS: p=0.4049). Conclusions: We confirmed that cases of IMLN and/or LLN metastasis in low rectal cancer tend to have a large total number of metastatic lymph nodes, but a good outcome can be expected if curative resection can be performed. These results demonstrate the value of radical Japanese D3 lymph node dissection in low rectal cancer with IMLN and/or LLN metastasis.

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Nakamura, T., and M. Watanabe. "Lateral Lymph Node Dissection for Lower Rectal Cancer." World Journal of Surgery 37, no. 8 (May 24, 2013): 1808–13. http://dx.doi.org/10.1007/s00268-013-2072-z.

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Lim, Raymond Z. M., Juin Y. Ooi, Jih H. Tan, Henry C. L. Tan, and Seniyah M. Sikin. "Outcome of Cervical Lymph Nodes Dissection for Thyroid Cancer with Nodal Metastases: A Southeast Asian 3-Year Experience." International Journal of Surgical Oncology 2019 (February 28, 2019): 1–6. http://dx.doi.org/10.1155/2019/6109643.

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Introduction. Therapeutic nodal dissection is still the mainstay of treatment for patients with lymph node metastases in many centres. The local data, however, on the outcome of therapeutic LND remains limited. Hence, this study aims to inform practice by presenting the outcomes of LND for thyroid cancer patients and our experience in a tertiary referral centre.Methods. This is a single-centre retrospective observational study in a Malaysian tertiary endocrine surgery referral centre. Patients who underwent total thyroidectomy with lymph node dissection between years 2013 and 2015 were included and electronic medical records over a 3-year follow-up period were reviewed. The outcomes of different lymph node dissection (LND), including central neck dissection, lateral neck dissection, or both, were compared.Results. Of the 43 subjects included, 28 (65.1%) had Stage IV cancer. Among the 43 subjects included, 8 underwent central LND, and 15 had lateral LND while the remaining 20 had dissection of both lateral and central lymph nodes. Locoregional recurrence was found in 16 (37.2%) of our subjects included, with no statistical difference between the central (2/8), lateral (7/15), and both (7/20). Postoperative hypocalcaemia occurred in 7 (16.3%) patients, and vocal cord palsy occurred in 5 (11.6%), whereas 9 patients (20.9%) required reoperation. Death occurred in 4 of our patients.Conclusion. High recurrence and reoperative rates were observed in our centre. While the routine prophylactic LND remains controversial, high risk patients may be considered for prophylactic LND. The long-term risk and benefit of prophylactic LND with individualised patient selection in the local setting deserve further studies.

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Aboelatta, Ibrahim H., Soliman A. El-Shakhs, Abd Elmieniem F. Mohammed, and Mohammed H. Milegy. "Role of pelvic lymphadenectomy in rectal cancer." International Surgery Journal 6, no. 6 (May 28, 2019): 1838. http://dx.doi.org/10.18203/2349-2902.isj20192150.

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Background: Rectal cancer constitutes about one third of all colorectal cancer cases. Total mesorectal excision has become the gold standard in rectal cancer treatment. However total mesorectal excision does not involve any approaches for lateral pelvic lymph nodes (LPLN), which may be asource of local recurrences. Tumor containing LPLN were reported to be found in about 10%-20% of the rectal cancer patients. In japan lateral pelvic lymph node metastasis is accepted to be curable with excision.Methods: This study included 20 patients presented to Menofia Hospital for elective colorectal re sections and LPLN dissection, in the period from July 2016 to January 2019.Results: This study on 13 male (65%), 7 female (35%), all patients included in the study underwent preoperative chemoradiation according to the technique described by Marks et al. with an overall administration of 45 cGy over 5 weeks. Dissection of 180 lymph nodes was retrieved (20%) lymph nodes pathologically were positive for malignancy.Conclusions: Lateral pelvic lymph nodes dissection is an important in rectal cancer treatment.

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Graceffa, Giuseppa, Giuseppina Orlando, Gianfranco Cocorullo, Sergio Mazzola, Irene Vitale, Maria Pia Proclamà, Calogera Amato, et al. "Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation." Journal of Clinical Medicine 10, no. 15 (July 30, 2021): 3407. http://dx.doi.org/10.3390/jcm10153407.

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Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).

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Danforth, D. N., P. A. Findlay, H. D. McDonald, M. E. Lippman, C. M. Reichert, T. d'Angelo, C. R. Gorrell, N. L. Gerber, A. S. Lichter, and S. A. Rosenberg. "Complete axillary lymph node dissection for stage I-II carcinoma of the breast." Journal of Clinical Oncology 4, no. 5 (May 1986): 655–62. http://dx.doi.org/10.1200/jco.1986.4.5.655.

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We reviewed the complete axillary dissection specimens of 136 patients with stage I-II breast cancer to clarify the distribution of axillary lymph node metastases in this disease. Our series included 71 patients undergoing axillary dissection as part of a modified radical mastectomy (MRM) and 65 patients undergoing axillary dissection in conjunction with conservative surgery of the breast and definitive postoperative breast radiotherapy (CAD). These two groups of patients were comparable according to age, menopausal status, tumor size, and clinical stage. In all patients the pectoralis minor muscle was excised and all axillary tissue removed. Each specimen contained a median of 23 lymph nodes. The axillary levels (I, II, III) were determined according to the relationship of axillary tissue to the pectoralis minor muscle (lateral, inferior, medial). Thirty-nine percent of the lymph nodes were contained in level I, 41% in level II, and 20% in level III. There were no significant differences noted in the number of lymph nodes or in the distribution of lymph nodes according to axillary level between dissections performed as part of the MRM or those done as a single procedure (CAD). Sixty-five patients (47.8%) had one or more positive lymph nodes in their axillary specimen. The clinical and pathologic stage was determined and compared for all patients. Among patients judged to have a clinically negative axilla, 37.6% had histologically positive lymph nodes (clinical false-negative rate). For patients with a clinically positive axilla, 11.1% had, histologically, no evidence of metastatic disease (clinical false-positive rate). When the distribution of lymph node metastases according to axillary level was studied, it was found that 29.2% of lymph node-positive patients (or 14.0% of all patients) had metastases only to level II and/or III of the axilla, with level I being negative (skip metastases). This incidence of skip metastases was greater among clinically node-negative than among clinically node-positive patients, but was not related to the size or location of the primary tumor in the breast. In addition, it was found that 20.0% of lymph node-positive patients (or 9.6% of all patients) were converted from three or fewer to four or more positive nodes by analysis of lymph nodes contained in levels II and III. This conversion from three or fewer to four or more positive nodes was due primarily to information contained in level II, with level III contributing to a smaller degree.(ABSTRACT TRUNCATED AT 400 WORDS)

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Oi, Haruka, Takashi Okuyama, Shinichi Sameshima, Emiko Takeshita, Masatoshi Oya, and Yoshiya Fujimoto. "A Case with Residual Obturator Lymph Node Resected Laparoscopically after Lateral Lymph Node Dissection." Nippon Daicho Komonbyo Gakkai Zasshi 72, no. 8 (2019): 509–15. http://dx.doi.org/10.3862/jcoloproctology.72.509.

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Chung, Yoo Seung, Jee Young Kim, Ja-Seong Bae, Byung-Joo Song, Jeong Soo Kim, Hae Myung Jeon, Sang-Seol Jeong, Eung Kook Kim, and Woo-Chan Park. "Lateral Lymph Node Metastasis in Papillary Thyroid Carcinoma: Results of Therapeutic Lymph Node Dissection." Thyroid 19, no. 3 (March 2009): 241–46. http://dx.doi.org/10.1089/thy.2008.0244.

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Noel, Julia E., and Lisa A. Orloff. "Recognizing Persistent Disease in Well-Differentiated Thyroid Cancer and Association with Lymph Node Yield and Ratio." Otolaryngology–Head and Neck Surgery 162, no. 1 (October 29, 2019): 50–55. http://dx.doi.org/10.1177/0194599819886123.

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Objective To establish the association between lymph node yield and ratio in neck dissection for well-differentiated thyroid cancer and risk for persistent postoperative disease. Study Design Retrospective cohort study of patients undergoing lymphadenectomy for thyroid carcinoma. Setting Tertiary referral center. Subjects and Methods Included patients underwent central and/or lateral neck dissection for papillary thyroid carcinoma at our institution between 1994 and 2015. They were divided into a persistent disease group with biochemical and structural disease (49 patients) and a disease-free group with no disease after a minimum 2 years of follow-up (175 patients). Demographic characteristics, adjuvant therapy, tumor, and lymph node features were compared. Results There were no significant differences in demographic characteristics between the groups. The mean nodal yield of patients with central and lateral neck persistence was significantly lower than that of patients remaining disease free (4.8 vs. 11.9: odds ratio [OR] 0.69; 95% CI, 0.59 to 0.8; P < .001; 14.8 vs. 31.0: OR, 0.89; 95% CI, 0.84-0.94; P < .001, respectively). Nodal ratio was higher in patients with persistence in the central and lateral neck (74.2% vs 29.4%: OR, 1.06; 95% CI, 1.04-1.08; P < .001; 54.2% vs 19.8%: OR, 1.08; 95% CI, 1.04-1.12; P < .001, respectively). Conclusions Lower lymph node yield and higher node ratio from cervical lymph node dissections are associated with persistent disease and have potential applications in surgical adequacy.

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Ling, Yuwei, Jing Zhao, Ye Zhao, Kaifu Li, Yajun Wang, and Hua Kang. "Role of intraoperative neuromonitoring of recurrent laryngeal nerve in thyroid and parathyroid surgery." Journal of International Medical Research 48, no. 9 (September 2020): 030006052095264. http://dx.doi.org/10.1177/0300060520952646.

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Objective To investigate whether intraoperative neuromonitoring (IONM) has a significant advantage in reducing the incidence of recurrent laryngeal nerve (RLN) injury. Methods Patients who underwent thyroid and parathyroid surgery from October 2012 to December 2017 at the Center for Thyroid and Breast Surgery of Xuanwu Hospital were retrospectively analyzed. They were divided into the IONM group and visualization alone group (VA group) according to whether IONM was used. Results In total, 1696 nerves at risk of injury (IONM group, n = 1104; VA group, n = 592) were included in the analysis. Among the high-risk nerves, permanent damage occurred in no cases in the IONM group but in one case in the VA group. Because the higher proportion of central lymph node metastasis caused difficulties in central cervical lymph node dissection and identification of the RLN, the patients undergoing lateral cervical lymph node dissection in the VA group had a significantly higher risk of postoperative RLN injury (11.76% vs. 0.00%). Conclusion IONM technology has advantages in protection of the RLN, especially in high-risk nerves and patients with a high proportion of central lymph node metastasis who require central and lateral cervical lymph node dissection.

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Siddiqi, Najaf N., Samuel S. Stefan, and Jim S. Khan. "Robotic Abdominoperineal Excision with Lateral Pelvic Lymph Node Dissection." Diseases of the Colon & Rectum 64, no. 3 (December 31, 2020): e58-e59. http://dx.doi.org/10.1097/dcr.0000000000001943.

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Malakorn, Songphol, Akira Ouchi, Tarik Sammour, Brian K. Bednarski, and George J. Chang. "Robotic Lateral Pelvic Lymph Node Dissection after Neoadjuvant Chemoradiation." Diseases of the Colon & Rectum 61, no. 9 (September 2018): 1119–20. http://dx.doi.org/10.1097/dcr.0000000000001170.

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Muraki, Ryuta, Masayoshi Yamamoto, Shintaro Ishikawa, Takahumi Kawamura, Hayato Kosaka, Hisahito Ishimatsu, Ryuhei Hara, Takashi Harada, Kiyotaka Kurachi, and Hiroyuki Konno. "Rectal Neuroendocrine of a Tumor with Only Lateral Lymph Node Metastases Treated by Laparoscopic Lateral Lymph Node Dissection." Japanese Journal of Gastroenterological Surgery 50, no. 5 (2017): 409–15. http://dx.doi.org/10.5833/jjgs.2015.0224.

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Tokuoka, Masayoshi, Yoshihito Ide, Mitsunobu Takeda, Yasuji Hashimoto, Jin Matsuyama, Shigekazu Yokoyama, Takashi Morimoto, et al. "Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach." International Surgery 100, no. 3 (March 1, 2015): 417–22. http://dx.doi.org/10.9738/intsurg-d-14-00091.1.

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We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer.

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Fan, Weina, Cheng Xiao, and Fusheng Wu. "Analysis of risk factors for cervical lymph node metastases in patients with sporadic medullary thyroid carcinoma." Journal of International Medical Research 46, no. 5 (March 23, 2018): 1982–89. http://dx.doi.org/10.1177/0300060518762684.

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Objective Medullary thyroid carcinoma (MTC) is classified as either sporadic or inherited. This study was performed to analyze the risk factors for cervical lymph node metastases and predict the indication for prophylactic lateral neck dissection in patients with sporadic MTC. Methods Sixty-five patients with sporadic MTC were retrospectively reviewed. Univariate analysis with the chi-square test and multiple logistic regression analysis were applied to identify the clinicopathological features (sex, age, tumor size, number of tumor foci, capsule or vascular invasion, and others) associated with cervical lymph node metastases. Results The metastasis rates in the central and lateral compartments were 46.2% (30/65) and 40.0% (26/65), respectively. The incidence of cervical lymph node metastases was significantly higher in patients with a tumor size of >1 cm, tumor multifocality, and thyroid capsule invasion. Only thyroid capsule invasion was an independent predictive factor for central compartment metastases and lateral neck metastases. The possibility of central compartment metastases was significantly higher when the preoperative serum carcinoembryonic antigen concentration was >30 ng/mL (60.0% vs. 34.3%). Conclusions MTC is associated with a high incidence of cervical lymph node metastases. Prophylactic lateral node dissection is necessary in patients with thyroid capsule invasion or a high serum carcinoembryonic antigen concentration.

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Oshikiri, Taro, Tetsu Nakamura, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Satoshi Suzuki, and Yoshihiro Kakeji. "VS01.04: RELIABLE SURGICAL TECHNIQUES FOR LYMPHADENECTOMY ALONG THE LEFT RECURRENT LARYNGEAL NERVE DURING THORACOSCOPIC ESOPHAGECTOMY IN THE PRONE POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 44. http://dx.doi.org/10.1093/dote/doy089.vs01.04.

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Abstract Description Background Lymphadenectomy along the left recurrent laryngeal nerve (RLN) in esophageal cancer is important for disease control but requires advanced dissection skills. Complete dissection of the lymph nodes along the left RLN in a safe manner is important. We demonstrate the reliable method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the prone position (TEP). Methods This procedure is performed for all of resectable thoracic esophageal cancers. The essence of this method is to recognize the lateral pedicle as a two-dimensional membrane that inclu replicatedes the left RLN, lymph nodes around the nerve, and primary esophageal arteries. By drawing the proximal portion of the divided esophagus and the lateral pedicle, identification and reliable cutting of the primary esophageal arteries and distinguishing the left RLN from the lymph nodes are simplified. Results We performed 46 TEPs for esophageal cancer using this method with no conversion to an open procedure in 2015 at Kobe University. No intraoperative morbidity related to the left RLN was observed. The mean number of harvested lymph nodes along the left RLN was 6.9 ± 4.2. Left RLN palsy greater than Clavien-Dindo classification grade II occurred in 4 patients (8%), all of them were reversible. The incidence of lymph node metastasis along the left RLN was 22%. Conclusion Our method for lymphadenectomy along the left RLN during TEP is safe and reliable. It has a low incidence of left RLN palsy and provides sufficient lymph node dissection along the left RLN. Disclosure All authors have declared no conflicts of interest.

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Bardet, Stéphane, Elodie Malville, Jean-Pierre Rame, Emmanuel Babin, Guy Samama, Dominique De Raucourt, Jean-Jacques Michels, Yves Reznik, and Michel Henry-Amar. "Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma." European Journal of Endocrinology 158, no. 4 (April 2008): 551–60. http://dx.doi.org/10.1530/eje-07-0603.

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ObjectiveWhether lymph-node dissection (LND) influences the lymph-node recurrence (LNR) risk in patients with papillary thyroid cancer remains controversial. The prognostic impact of macroscopic and microscopic lymph-node involvement at diagnosis is also an unresolved issue. A retrospective study was conducted to assess the influence of various LND procedures and to search for LNR risk factors.MethodsOverall 545 patients without distant metastases prior to surgery and main tumour ≥10 mm were included. A total thyroidectomy was performed in all patients with either no LND (Group 1,n=161), bilateral LND of the central and lateral compartments (Group 2,n=181) or all other dissection modalities (Group 3,n=203). Post-operative radioiodine was given to 496 (91%) patients. The 10-year cumulative probability of LNR was assessed and a prognostic study using multivariate analysis was performed.ResultsMacroscopic lymph-node metastases were present in 118 patients, 57 diagnosed before surgery and 61 only at surgery (including 81% in the central compartment). Overall, the 10-year cumulative probability of LNR was 7%. Macroscopic lymph-node metastases (P=0.001), extra-thyroidal invasion (P=0.017) and male gender (P=0.05) were independent risk factors, while bilateral LND of the central and lateral compartments was protective (P=0.028). In patients with macroscopic lymph-node metastases, the 10-year probability was lower in Group 2 than in Group 3 (10% vs 30%,P<0.01). In patients without macroscopic lymph-node metastases (n=427), no significant differences were observed between the three LND groups.ConclusionsPatients with macroscopic, but not microscopic, lymph-node involvement have a major LNR risk and need an optimal LND at primary surgery.

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De Napoli, Luigi, Antonio Matrone, Karin Favilla, Paolo Piaggi, David Galleri, Carlo Enrico Ambrosini, Alexander Aghababyan, et al. "ROLE OF PROPHYLACTIC CENTRAL COMPARTMENT LYMPH NODE DISSECTION ON THE OUTCOME OF PATIENTS WITH PAPILLARY THYROID CARCINOMA AND SYNCHRONOUS IPSILATERAL CERVICAL LYMPH NODE METASTASES." Endocrine Practice 26, no. 8 (August 2020): 807–17. http://dx.doi.org/10.4158/ep-2019-0532.

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Objective: Prophylactic central compartment lymph node dissection (pCCND) results in a higher percentage of surgical-related complications. To date, no evidence of the impact of pCCND on the clinical outcome of papillary thyroid carcinoma (PTC) patients with synchronous ipsilateral cervical lymph node metastases has been reported. Methods: We evaluated all consecutive patients affected by PTC and synchronous ipsilateral cervical, but without evidence of central compartment, lymph node metastases. We selected 54 consecutive patients (group A) treated by total thyroidectomy, ipsilateral cervical lymph node dissection, and pCCND and 115 patients (group B) matched for sex, age at diagnosis, number and dimension of the metastatic lateral cervical lymph nodes, without pCCND. Clinical outcome after a median of 5 years and surgical-related complications were assessed. Results: The two groups were completely similar in terms of clinical features. Clinical outcomes showed a higher percentage of biochemical and indeterminate but not structural response in group B. Group B required significantly more radioiodine treatments, but no difference was shown in the need to repeat surgery for recurrences. Conversely, the prevalence of permanent hypoparathyroidism was significantly higher in group A (14.8%) than in group B (4.3%). Conclusion: In PTC patients with synchronous ipsilateral cervical lymph node metastases, in absence of clinically evident lymph node metastases of the central compartment, performing pCCND does not improve the 5-year outcome in terms of structural disease, despite a greater number of 131I treatments. However, pCCND is severely affected by a higher percentage of permanent hypoparathyroidism, even in the hands of expert surgeons. Abbreviations: IQR = interquartile range; pCCND = prophylactic central compartment lymph node dissection; PTC = papillary thyroid carcinoma; Tg = thyroglobulin; US = ultrasound

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Yang, Peipei, Jianming Li, Haoyu Jing, Qiyang Chen, Xinxin Song, and Linxue Qian. "Effect of Prophylactic Central Lymph Node Dissection on Locoregional Recurrence in Patients with Papillary Thyroid Microcarcinoma." International Journal of Endocrinology 2021 (November 15, 2021): 1–7. http://dx.doi.org/10.1155/2021/8270622.

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There is a consensus that central compartment lymph node dissection or modified radical lateral neck dissection should be performed in papillary thyroid microcarcinoma (PTMC) patients with lymph node metastases. Prophylactic central lymph node dissection (PCLND) in patients with clinically node-negative (cN0) PTMC to reduce locoregional recurrence (LRR) rate and improve prognosis remains controversial. The present study aimed to analyze the effect of PCLND on LRR and postoperative complications of PTMC in cN0 patients. We reviewed a cohort of patients with cN0 PTMC who underwent surgery between January 1997 and October 2019. The patients were divided into the PCLND and no lymph node dissection (NLND) groups. Kaplan–Meier curves were constructed to estimate 15-year locoregional recurrence-free survival rate of the two groups, and the difference was compared by the log-rank test. Three Cox regression models were performed to evaluate the correlation between PCLND and LRR. All patients underwent thyroidectomy, and 25 patients developed LRR; of whom, 23 underwent PCLND at initial surgery and 2 went without lymph node dissection. Cox regression analysis showed that PCLND had no effect on LRR. Postoperative hematoma and permanent recurrent laryngeal nerve injury did not occur in the NLND group, and their incidences were 0.5% and 0.3% in the PCLND group, respectively. PCLND had no significant correlation with LRR in patients with cN0 PTMC, and the absolute benefit for PTMC was small.

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Nakayama, T., M. Watanabe, T. Teramoto, M. Kitajima, and S. Kodaira. "The Significance of Lateral Lymph Node Dissection for Rectal Cancer." Nippon Daicho Komonbyo Gakkai Zasshi 48, no. 2 (1995): 144–49. http://dx.doi.org/10.3862/jcoloproctology.48.144.

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Alturkistani, Suhail Abdullah, Alanoud Mohammed Alghanem, and In Kyu Lee. "Robotic Lateral Pelvic Lymph Node Dissection: Description of A Technique." Journal of Minimally Invasive Surgery 23, no. 2 (June 15, 2020): 103–5. http://dx.doi.org/10.7602/jmis.2020.23.2.103.

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Chen, Tzu-Chun, and Jin-Tung Liang. "Robotic Lateral Pelvic Lymph Node Dissection for Distal Rectal Cancer." Diseases of the Colon & Rectum 59, no. 4 (April 2016): 351–52. http://dx.doi.org/10.1097/dcr.0000000000000536.

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Cribb, Benjamin, Joseph Kong, Jacob McCormick, Satish Warrier, and Alexander Heriot. "Lateral pelvic lymph node dissection for rectal cancer: unfinished business?" ANZ Journal of Surgery 90, no. 7-8 (July 2020): 1228–29. http://dx.doi.org/10.1111/ans.15761.

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Yano, Hideaki, Brendan J. Moran, Toshiaki Watanabe, and Kenichi Sugihara. "Lateral pelvic lymph-node dissection: still an option for cure." Lancet Oncology 11, no. 2 (February 2010): 114. http://dx.doi.org/10.1016/s1470-2045(09)70361-4.

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Aiba, T., K. Uehara, T. Mukai, N. Hattori, G. Nakayama, and M. Nagino. "Transanal extended rectal surgery with lateral pelvic lymph node dissection." Techniques in Coloproctology 22, no. 11 (November 2018): 893–94. http://dx.doi.org/10.1007/s10151-018-1891-1.

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Nakanishi, Ryota, Tomohiro Yamaguchi, Takashi Akiyoshi, Toshiya Nagasaki, Satoshi Nagayama, Toshiki Mukai, Masashi Ueno, Yosuke Fukunaga, and Tsuyoshi Konishi. "Laparoscopic and robotic lateral lymph node dissection for rectal cancer." Surgery Today 50, no. 3 (January 27, 2020): 209–16. http://dx.doi.org/10.1007/s00595-020-01958-z.

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Watanabe, T., and K. Hata. "Robotic surgery for rectal cancer with lateral lymph node dissection." British Journal of Surgery 103, no. 13 (November 30, 2016): 1755–57. http://dx.doi.org/10.1002/bjs.10412.

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Fujita, S., S. Yamamoto, T. Akasu, and Y. Moriya. "Lateral pelvic lymph node dissection for advanced lower rectal cancer." British Journal of Surgery 90, no. 12 (2003): 1580–85. http://dx.doi.org/10.1002/bjs.4350.

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Chen, Zhongyan, Zhiming Zhong, Guoqing Chen, and Yun Feng. "Application of Carbon Nanoparticles in Neck Dissection of Clinically Node-Negative Papillary Thyroid Carcinoma." BioMed Research International 2021 (April 21, 2021): 1–7. http://dx.doi.org/10.1155/2021/6693585.

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Purpose. The purpose of this retrospective study was to evaluate the advantages of carbon nanoparticles in neck dissection and to conclude its application in the treatment of clinically node-negative papillary thyroid carcinoma (CN0PTC). Methods. As a retrospective cohort study, we divided the enrolled patients into two groups, the carbon nanoparticle (CN) group and the control group according to the usage of CN. In the CN group, CN was applied to reveal drainage lymph nodes and the picked LNs were sent for fast frozen testing. If metastasis exits, modified radical lateral lymph node dissection (LLND) was performed. For both groups, prophylactic central lymph node dissection was routinely done. Finally, the demographic information, tumor characteristics, postoperative pathological results, and laboratory data were collected for analysis. Results. A total of 61 CN0PTC were enrolled in this study, 33 in the CN group and 28 in the control group. The black-stained rate for CN was 29/40 (72.5%) with a positive prediction rate of 34.5%. The mainly black-stained region in the lateral neck was level III and possesses the highest lymph node ratio (17.5%). The metastasis that occurred in level VI was 30% and 11.8% in the CN and control groups, respectively ( p = 0.058 ). During the available follow-up, no one showed recurrence. Statistical analysis showed that the CN suspension can significantly reduce the risk of damage to the parathyroid gland ( p = 0.001 for hypocalcemia, <0.05; p = 0.047 for hypoparathyroidism, <0.05). Conclusion. The lateral neck metastasis in patients with papillary thyroid microcarcinoma in clinical stage cT1aN0 is not rare. CN can help surgeons to distinguish the real person who actually needs LLND. In prophylactic CLND, CN acts as a tracer which makes the parathyroid gland more identifiable and avoids risks of injuries to nerves and glands.

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Christou, Niki, Jeremy Meyer, Christophe Combescure, Alexandre Balaphas, Joan Robert-Yap, Nicolas C. Buchs, and Frédéric Ris. "Prevalence of Metastatic Lateral Lymph Nodes in Asian Patients with Lateral Lymph Node Dissection for Rectal Cancer: A Meta-analysis." World Journal of Surgery 45, no. 5 (February 4, 2021): 1537–47. http://dx.doi.org/10.1007/s00268-021-05956-1.

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AbstractImportanceRectal cancers occupy the eighth position worldwide for new cases and deaths for both men and women. These cancers have a high tendency to form metastases in the mesorectum but also in the lateral lymph nodes. The therapeutic approach for the involved lateral lymph nodes remains controversial.ObjectiveWe performed a systematic review and meta-analysis to assess the prevalence of metastatic lateral lymph nodes in patients with lateral lymph node dissection (LLND) for rectal cancer, which seems to be a fundamental and necessary criterion to discuss any possible indications for LLND.MethodsData sources–study selection–data extraction and synthesis–main outcome and measures. We searched MEDLINE, EMBASE and COCHRANE from November 1, 2018, to November 19, 2018, for studies reporting the presence of metastatic lateral lymph nodes (iliac, obturator and middle sacral nodes) among patients undergoing rectal surgery with LLND. Pooled prevalence values were obtained by random effects models, and the robustness was tested by leave-one-out sensitivity analyses. Heterogeneity was assessed using the Q-test, quantified based on the I2 value and explored by subgroup analyses.ResultsOur final analysis included 31 studies from Asian countries, comprising 7599 patients. The pooled prevalence of metastatic lateral lymph nodes was 17.3% (95% CI: 14.6–20.5). The inter-study variability (heterogeneity) was high (I2 = 89%). The pooled prevalence was, however, robust and varied between 16.6% and 17.9% according to leave-one-out sensitivity analysis. The pooled prevalence of metastatic lymph nodes was not significantly different when pooling only studies including patients who received neoadjuvant treatment or those without neoadjuvant treatment (p = 0.44). Meta-regression showed that the pooled prevalence was associated with the sample size of studies (p < 0.05), as the prevalence decreased when the sample size increased.ConclusionThe pooled prevalence of metastatic lateral lymph nodes was 17.3% among patients who underwent rectal surgery with LLND in Asian countries. Further studies are necessary to determine whether this finding could impact the therapeutic strategy (total mesorectal excision with LLNDversustotal mesorectal excision with neoadjuvant radiochemotherapy).

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Kadhim, Salah Hadi, Karrar Ibrahim Mahmood, and Mohammed Mohammud Habash. "The Role of Prophylactic Cervical Lymph Node Dissection with Total Thyroidectomy in Prevention Recurrence of Papillary Thyroid Carcinoma." Open Access Macedonian Journal of Medical Sciences 10, B (May 10, 2022): 1372–76. http://dx.doi.org/10.3889/oamjms.2022.9436.

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AIM: It is assess benefit prophylactic selective unilateral cervical lymph node (LN) dissection with total thyroidectomy for patients who have papillary thyroid carcinoma (PTC) and negative cervical lymph nodes metastasis and determination recommended risk factors for such surgery. METHODS: This was a prospective study, 60 patients with PTC investigated by Fine needle aspiration, ultrasonography to support diagnosis patients with PTC, and negative lymph node metastasis. Nineteen patients are excluded from the entire 60 patients; remaining 41 patients are submitted to a total thyroidectomy and prophylactic selective one side ipsilateral lateral and central lymph nodes dissection (level II, III, IV, and V). Then, follow-up 2 years for all patients, postoperatively, for detection PTC recurrence. RESULTS: The result shows that from the total 41 patients, two groups are positive and negative lymph nodes metastasis 24.4% (10) and 75.6% (31), respectively, positive lymph nodes metastasis is presented more in male 7 (70%) with significant difference (p = 0.03) and age groups <55 years old 6 (60%) with insignificant association (p = 0.413). Thyroid nodular size (>1 cm) and multiple nodules presented more in positive lymph nodes metastasis with significant difference in both. Multivariate binary logistic regression, sex, thyroid multinodularity, and thyroid nodule size were insignificant relationship of prediction of lymph nodes metastasis. CONCLUSION: Prophylactic cervical LN dissection with total thyroidectomy for patients with PTC and negative cervical lymph nodes metastasis has beneficial role in preventing recurrence of PTC. Risk factors such as male gender, thyroid multinodularity (multiple nodule), and their size (>1 cm) have role in increasing chance of occurrence of cervical LN metastasis.

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Sato, Harunobu, Koutarou Maeda, and Morito Maruta. "Prognostic significance of lateral lymph node dissection in node positive low rectal carcinoma." International Journal of Colorectal Disease 26, no. 7 (March 12, 2011): 881–89. http://dx.doi.org/10.1007/s00384-011-1170-3.

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Hacker, Neville F., Ellen Barlow, Stephen Morrell, and Katrina Tang. "Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival." Cancers 13, no. 22 (November 19, 2021): 5806. http://dx.doi.org/10.3390/cancers13225806.

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Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this risk. Methods: We included patients with vulvar cancer of any histological type, even if the cancer extended medially to involve the urethra, anus, or vagina. We excluded patients whose tumor extended (i) laterally onto the thigh, (ii) posteriorly onto the buttocks, or (iii) anteriorly onto the mons pubis. After resection, the inguinal nodes were divided into a medial and a lateral group, based on the lateral border of the femoral artery. Results: Between December 2010 and July 2018, 76 patients underwent some form of groin node dissection, and data were obtained from 112 groins. Approximately one-third of nodes were located lateral to the femoral artery. Positive groin nodes were found in 29 patients (38.2%). All patients with positive nodes had positive nodes medial to the femoral artery. Five patients (6.6%) had positive lateral inguinal nodes. The probability of having a positive lateral node given a negative medial node was estimated to be 0.00002. Conclusion: Provided the medial nodes are negative, medial inguino-femoral lymphadenectomy may suffice and should reduce lower limb lymphedema without compromising survival.

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Sato, Hiroshi, Yutaka Miyawaki, Masayasu Aikawa, Kojun Okamoto, Shinichi Sakuramoto, Shigeki Yamaguchi, and Isamu Koyama. "PS02.013: THORACOSCOPIC ESOPHAGECTOMY WITH RADICAL LYMPH NODE DISSECTION FOR THORACIC ESOPHAGEAL CARCINOMA IN THE LEFT LATERAL DECUBITUS POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 124. http://dx.doi.org/10.1093/dote/doy089.ps02.013.

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Abstract Background The rates of thoracoscopic esophagectomy performed in the prone and left lateral decubitus positions are similar in Japan. We retrospectively reviewed short term outcomes of thoracoscopic esophagectomy for esophageal cancer performed in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation in a single institution. This study aimed to evaluate the feasibility of applying this procedure. Methods Between July 2013 and March 2017, 83 patients with esophageal cancer underwent thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation. The thoracic procedure is performed as follows: The lymph nodes around the right recurrent laryngeal nerve are dissected. On the cranial side, the lymph node dissection is advanced to the level of the inferior thyroid artery. Then, the assistant rotates the trachea toward the ventral side, and the lymph nodes around the left recurrent laryngeal nerve are dissected. The middle and inferior mediastinal lymph nodes are dissected including supradiaphragmatic lymph nodes and the dorsal lymph nodes around the thoracic descending aorta. Then, the esophagus is transected using an automatic suture device. Finally, the tracheal bifurcation area lymph nodes are dissected. We retrospectively analyzed these patients. Results The completion rate of thoracoscopic esophagectomy was 94.0%, and the procedure was converted to thoracotomy in five patients, due to hemorrhage, severe adhesion. The mean intrathoracic operative time, intrathoracic blood loss, and number of dissected mediastinal lymph nodes were 220.0 min, 130.1 mL, and 22.0, respectively. Postoperative complications included pneumonia (8.4%), anastomotic leakage (16.9%), and recurrent nerve paralysis (8.4%). Postoperative (30d) mortality was 1/83 (1.2%) due to ARDS. Conclusion Standardization of the procedure for thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation, with a standardized clinical pathway for perioperative care led to favorable surgical outcomes. Disclosure All authors have declared no conflicts of interest.

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Jiang, Yu-Juan, Si-Cheng Zhou, Jing-Hua Chen, and Jian-Wei Liang. "Oncologic Benefit of Adjuvant Therapy in Lateral Pelvic Lymph Node Metastasis following Neoadjuvant Chemoradiotherapy and Lateral Pelvic Lymph Node Dissection." Journal of Cancer 13, no. 13 (2022): 3427–33. http://dx.doi.org/10.7150/jca.77689.

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Ishikawa, Takahisa, Shigenori Homma, Makoto Nishikawa, Hiroki Nakamoto, Ryoji Yokoyama, and Akinobu Taketomi. "Laparoscopic abdominoperineal resection with lateral lymph node dissection for advanced rectal and prostate cancer with synchronous lateral lymph node metastases." Asian Journal of Endoscopic Surgery 12, no. 1 (May 10, 2018): 118–21. http://dx.doi.org/10.1111/ases.12598.

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Shiga, Kiyoto, Katsunori Katagiri, and Daisuke Saito. "PS01.126: LYMPH NODE METASTASES AND NECK DISSECTION FOR THE PATIENTS WITH CERVICAL ESOPHAGEAL CANCER." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 85. http://dx.doi.org/10.1093/dote/doy089.ps01.126.

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Abstract Background Cervical esophageal cancer (CEC) is a relatively rare disease but the outcomes of the patients with CEC are often poor. Lymph node metastases in the neck sometimes play a crucial role to treat the patients. The aim of this study is to evaluate the lymph node metastases and neck dissection for the patients with CEC. Methods Retrospective review of the records of the patients. Five patients with CEC who underwent total pahryngo-laryngectomy plus cervical esophagectomy were enrolled in this study. We analyzed the places of lymph node metastases of the patients and the relationship of the patients’ outcome. Results Four of the patients underwent free jejunum flap reconstruction after total pahryngo-laryngectomy plus cervical esophagectomy and the other one underwent gastric tube plus free jejunum flap reconstruction after the pahryngo-laryngectomy plus total esophagectomy. All patients underwent bilateral neck dissection. One patient underwent chemoradiotherapy as an initial treatment and he had no lymph node metastasis by pathological examination. The other four patients had neck metastases to some extent. Three of them had bilateral lymph node metastases and the other had one metastatic lymph node. Especially one patient had left upper lateral neck metastasis and right Rouvier lymph node metastasis. Conclusion These results indicated that patients with CEC should undergo bilateral neck dissection and if possible, Rouvier lymph node should also be resected during radical surgery. Disclosure All authors have declared no conflicts of interest.

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Parshin, V. S., A. D. Kaprin, S. A. Ivanov, A. A. Veselova, P. I. Garbuzov, and V. S. Medvedev. "Ultrasound diagnosis of cervical lymph node metastases in patients with first diagnosed papillary thyroid cancer and in patients previously treated surgically and admitted for radioactive iodine therapy." Research and Practical Medicine Journal 7, no. 2 (June 25, 2020): 47–55. http://dx.doi.org/10.17709/2409-2231-2020-7-2-4.

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Purpose of the study. To evaluate the potentialities of ultrasound method in diagnosing cervical lymph node metastasis in patients with first diagnosed papillary thyroid cancer (group 1) and in patients previously treated surgically at different clinics of the Russian Federation and subsequently admitted to the A.F.Tsyb Medical Radiological Research Center — Branch of the National Medical Research Radiological Center to receive radioactive iodine therapy (group 2).Patients and methods. Patients with PTC were divided into two groups. Group 1 included 649 patients with first diagnosed PTC. All the patients underwent thyroidectomy and level VI lymph node neck dissection at the clinic of the A.F.Tsyb Medical Radiological Research Center — Branch of the National Medical Research Radiological Center. Of these patients, 92 patients underwent cervical lymph node dissection including levelsII–III–IV and 9 patients underwent cervical lymph node dissection including level VB. Group 2 consisted of 2875 patients who had previously received surgery at different clinics of the Russian Federation. Subsequently, they were admitted to our institution to receive radioactive iodine therapy. In 291 of these patients, cervical lymph node metastases were found and reoperations were performed: in 89 cases at level VI, in 170 cases at levels II–III–IV and in 32 cases at level VB. The detected metastases were verified histologically.Results. Histology confirmed the presence of nodal metastasis in 57.6% of 649 patients in group 1, and in 10.1% of 241 patients in group 2. In group 1, the incidence of metastatic disease in level VI nodes was 73% and in group 2, it was 30.6%. Metastases in levels II–III–IV were noted in 24.6% of patients in group 1, and in 58.4% of patients in group 2. Level VB metastasis was found in 2.4% of patients in group 1, and in 11% of patients in group 2. Multiple metastases were detected in 75.4% of patients in group 1, and in 20.3% of patients in group 2.Conclusion. Central lymph node metastasis was observed in 73% of patients who were first diagnosed with PTC and treated with thyroidectomy and prophylactic level VI cervical lymph node dissection. In group 2, solitary metastases to lateral lymph nodes occurred more frequently after surgical treatment for PTC, which suggested that the primary treatment was insufficiently radical.

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Kim, Jae-Myung, Ju-Yeon Kim, Eun Jung Jung, Eun Jin Song, Dong Chul Kim, Chi-Young Jeong, Young-Tae Ju, et al. "Cooccurrence of Metastatic Papillary Thyroid Carcinoma andSalmonellaInduced Neck Abscess in a Cervical Lymph Node." Case Reports in Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/5670429.

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Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC).Salmonellaspecies are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC andSalmonellainfection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II–IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence ofSalmonella Typhi. Following antibiotic sensitivity testing of the culturedSalmonella Typhi, she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management.

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Hall, Chad M., Samuel K. Snyder, and Terry C. Lairmore. "Central Lymph Node Dissection Improves Lymph Node Clearance in Papillary Thyroid Cancer Patients with Lateral Neck Metastases, Even after Prior Total Thyroidectomy." American Surgeon 84, no. 4 (April 2018): 531–36. http://dx.doi.org/10.1177/000313481808400426.

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The oncologic benefit of a central lymph node dissection (CLND) at the time of modified radical neck dissection (MRND) in patients with papillary thyroid cancer who have previously undergone a total thyroidectomy (TT) has not been studied. Patients with lateral cervical metastases were divided into two treatment groups: the concurrent cohort (TT with CLND and MRND), and the interval cohort (CLND and MRND after prior TT). Primary outcomes were lymph node metastases, skip metastases, level VI cancer recurrence, hypoparathyroidism and recurrent laryngeal nerve injury. Treatment groups consisted of 63 and 16 patients in the concurrent and interval groups, respectively. More central lymph nodes were removed (15.4 ± 8.4 to 10.1 ± 5.2 ( P = 0.02)), but similar level VI lymph node metastasis occurred (92.0–93.8% ( P = 0.99)) in the concurrent group compared with the interval group, respectively. Skip metastases were identified in only 7.6 per cent of patients. The incidence of level VI recurrence and recurrent laryngeal nerve injury was 1.2 per cent. Three patients developed hypoparathyroidism (3.7%). All permanent morbidities occurred in the concurrent group. CLND at the time of MRND for metastatic papillary thyroid cancer frequently identifies level VI metastases and can be done with low operative morbidity by experienced endocrine surgeons, even in patients who have undergone a prior TT.

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Dorin, Vartolomei Mihai, Chibelean Calin Bogdan, Voidazan Septimiu, Martha Orsolya, Borda Angela, Boja Radu Mihail, and Dogaru Grigore Aloiziu. "How Far We Should Go with Pelvic Lymph Node Dissection on the Controlateral Side in Unifocal Muscle Invasive Bladder Cancer." Acta Medica Marisiensis 61, no. 3 (September 1, 2015): 180–83. http://dx.doi.org/10.1515/amma-2015-0047.

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Abstract Objectives. The purpose of this study was to determine the evolution of patients with unifocal lateral wall MIBC (muscle invasive bladder cancer) after cystectomy with PLND (pelvic lymph node disection) at the Urology Clinic in Tirgu Mures, and to determine tumor stage and lymph node status before and after radical cystectomy with PLND. Methods. This is a prospective study, conducted between 1 August 2012 to 31 July 2014 at Urology Clinic, with a median follow-up of 14 months (range 7-25). Inclusion criteria were: patients undergone cystectomy with PLND, and unifocal MIBC on the lateral wall of the bladder; exclusion criteria were: multiple bladder tumor, other location and clinical T stage > 3. Results. Forteen patients met the inclusion criteria, median age was 61 (range 55-72), 85.71 % were male. An increase in T3 patients was noticed from 1 to 5 cases, we noticed a decrease of N0 lymph nodes from 78.6% to 57.1% postoperatively and on the controlateral side the kappa coefficient between the preoperatively and postoperatively negative lymph nodes was 0.63. On the tumor side the most common location for positive lymph nodes was external iliac with 3 nodes (21.4 %) and obturator fossa with 4 nodes (28.6 %) and on the contralateral side 2 positive nodes (14.3 %, obturator fossa, external, internal and common iliac nodes). Conclusions. In unifocal bladder tumors, located on the lateral wall, PLND could be an alternative with comparable results with extended PLND especially in T1 and T2 patients associated with N0 before and after surgery.

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Ozmen, M. Mahir, Baris Zulfikaroglu, N. Ozlem Kucuk, Necdet Ozalp, Gulseren Aras, Tankut Koseoglu, and Mahmut Koç. "Lymphoscintigraphy in Detection of the Regional Lymph Node Involvement in Gastric Cancer." Annals of The Royal College of Surgeons of England 88, no. 7 (November 2006): 632–38. http://dx.doi.org/10.1308/003588406x149200.

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INTRODUCTION Involvement of regional lymph node is a critical sign in prognosis of gastric cancer. Radiological techniques are commonly used to evaluate the extension of gastric cancer. But their sensitivity and specificity are low especially in the early stage. Our aim was to assess the value of gastric lymphoscintigraphy in identifying regional lymph node involvement in patients with gastric cancer, as compared to the abdominal ultrasonography, computed tomography and postoperative histopathological evaluation. PATIENTS AND METHODS 50 patients (12 females) with a median age of 61 years (range, 35–73 years) were included in the study. Pre-operative staging in all cases included upper gastrointestinal endoscopy and biopsy, followed by ultrasound, computed tomography and lymphoscintigraphy. 148 MBq Technetium-99m lymphoscint was injected around the tumour during endoscopy and immediately after injection, anterior, lateral and posterior images were taken in 5-min intervals using a gamma camera. Findings were compared to the findings of other tests. The sensitivity, specificity, positive predictive value, and negative predictive value of each test were calculated and compared. RESULTS Histologically, 68% of cases (34/50) had metastasis in regional lymph nodes and all cases were accurately diagnosed by lymphoscintigraphy. Lymphoscintigraphy was significantly more sensitive for detecting lymph node involvement (P < 0.01). Both abdominal ultrasonography and CT had very low sensitivity in identifying lymph nodes. CONCLUSIONS Lymphoscintigraphy is a promising test in the identification of regional lymph nodes pre-operatively in patients with gastric cancer. It might help the surgeon to plan the extent of dissection before surgery which may decrease postoperative complications related to unnecessary extensive lymph node dissection.

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Di Meo, Giovanna, Francesco Paolo Prete, Giuseppe Massimiliano De Luca, Alessandro Pasculli, Lucia Ilaria Sgaramella, Francesco Minerva, Francesco Antonio Logoluso, Giovanna Calculli, Angela Gurrado, and Mario Testini. "The Value of Intraoperative Ultrasound in Selective Lateral Cervical Neck Lymphadenectomy for Papillary Thyroid Cancer: A Prospective Pilot Study." Cancers 13, no. 11 (May 31, 2021): 2737. http://dx.doi.org/10.3390/cancers13112737.

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(1) Background: Lymph node metastases from papillary thyroid cancer (PTC) are frequent. Selective neck dissection (SND) is indicated in PTC with clinical or imaging evidence of lateral neck nodal disease. Both preoperative ultrasound (PreUS) and intraoperative palpation or visualization may underestimate actual lateral neck nodal involvement, particularly for lymph-nodes located behind the sternocleidomastoid muscle, where dissection may also potentially increase the risk of postoperative complications. The significance of diagnostic IOUS in metastatic PTC is under-investigated. (2) Methods: We designed a prospective diagnostic study to assess the diagnostic accuracy of IOUS compared to PreUS in detecting metastatic lateral neck lymph nodes from PTC during SND. (3) Results: There were 33 patients with preoperative evidence of lateral neck nodal involvement from PTC based on PreUS and fine-needle cytology. In these patients, IOUS guided the excision of additional nodal compartments that were not predicted by PreUS in nine (27.2%) cases, of which eight (24.2%) proved to harbor positive nodes at pathology. The detection of levels IIb and V increased, respectively, from 9% (PreUS) to 21% (IOUS) (p < 0.0001) and from 15% to 24% (p = 0.006). (4) Conclusions: In the context of this study, IOUS showed higher sensitivity and specificity than PreUS scans in detecting metastatic lateral cervical nodes. This study showed that IOUS may enable precise SND to achieve oncological radicality, limiting postoperative morbidity.

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Caziuc, Alexandra, Diana Schlanger, Giorgiana Amarinei, Vlad Fagarasan, David Andras, and George Calin Dindelegan. "Preventing Breast Cancer-Related Lymphedema: Feasibility of Axillary Reverse Mapping Technique." Journal of Clinical Medicine 10, no. 23 (December 6, 2021): 5707. http://dx.doi.org/10.3390/jcm10235707.

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Introduction. Our study aimed to determine the feasibility of axillary reverse mapping (ARM) technique, the identification rate of ARM nodes and their metastatic involvement, as well as to identify the factors that influence the identification and metastatic involvement. Material and methods. In total, 30 breast cancer patients scheduled for axillary lymph node dissection were enrolled in our study. The lymphatic nodes that drain the arm were identified by injecting 1 mL of blue dye in the ipsilateral upper arm; then, the ARM nodes were resected along with the other lymph nodes and sent for histological evaluation. Results. Identification of ARM node was successful in 18 patients (60%) and 22.22% of the identified ARM lymph nodes had metastatic involvement. Patients with identified ARM nodes had a significant lower BMI and a statistically significant relationship between axillary lymph node status and ARM node metastases was proven. Most of ARM lymph nodes (96.3%) were found above the intercostobrachial nerve, under the axillary vein and lateral to the thoracodorsal bundle. Conclusions. The ARM procedure is easy to reproduce but might not be appropriate for patients with a high BMI. The rate of metastatic involvement of ARM nodes is significant and no factor can predict it, showing that the preservation of these nodes cannot be considered.

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Yamaguchi, Tomohiro, and Yusuke Kinugasa. "Safety and feasibility of robotic-assisted laparoscopic lateral lymph node dissection." Annals of Laparoscopic and Endoscopic Surgery 3 (January 17, 2018): 5. http://dx.doi.org/10.21037/ales.2018.01.01.

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Journal articles on the topic 'Lateral lymph node dissection'

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