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Lymph Node Yield Threshold in Lateral Neck Dissection for Papillary Thyroid Carcinoma

By: Kayci Reyer
Posted: Friday, December 11, 2020

According to research published in Ear, Nose & Throat Journal, there may be an association between lymph node yield and postoperative serum thyroglobulin levels in patients who have undergone lateral neck dissection for papillary thyroid carcinoma. Daniel J. Rocke, MD, JD, of the Duke Cancer Institute, and colleagues sought to determine the yield threshold that would indicate an adequate lateral neck dissection had been performed.

The study included 107 patients with papillary thyroid cancer who had undergone lateral neck dissection between 2006 and 2015. A meaningful relationship between lymph node yield and postoperative serum thyroglobulin levels (P = .004) was observed. However, no relationship between lymph node yield and radioiodine uptake on a thyroid scan (P = .64) was identified. The identified lymph node yield threshold was 42.96, which was linked to maximum variation in serum thyroglobulin level. Neither the high- (≥ 43) nor low-yield (< 43) groups were associated with radioiodine uptake, complication risk, or prolonged time in surgery (all P > .05). Still, the high-yield group was associated with lower log serum thyroglobulin levels. According to the authors, this finding may suggest a relationship between adequate lateral neck dissection and an 84.4% decrease in serum thyroglobulin levels.

Researchers noted that a lymph node yield threshold of 43 is unusually high and may result from the study’s relatively small sample size. “It does, however, offer evidence that a more complete neck dissection may be associated with improved outcomes,” wrote the authors. “This study should serve as a cornerstone for future prospective projects involving a larger data set to determine an applicable lymph node yield that correlates with favorable postoperative outcomes.”

Disclosure: The study authors reported no conflicts of interest.

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