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Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer

Yeungnam University Journal of Medicine 2020년 37권 4호 p.302 ~ 307
김완욱, 이지연, 정진향, 박호용, 김원화, 김혜정, 박지영, Tufano Ralph P.,
소속 상세정보
김완욱 ( Kim Wan-Wook ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Surgery
이지연 ( Lee Jee-Yeon ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Surgery
정진향 ( Jung Jin-Hyang ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Surgery
박호용 ( Park Ho-Yong ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Surgery
김원화 ( Kim Won-Hwa ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Radiology
김혜정 ( Kim Hye-Jung ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Radiology
박지영 ( Park Ji-Young ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Pathology
 ( Tufano Ralph P. ) - Johns Hopkins University School of Medicine Department of Otolaryngology-Head and Neck Surgery

Abstract


Background: This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon’s palpation in papillary thyroid cancer.

Methods: This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness.

Results: Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively.

Conclusion: Determination of central LN metastasis by a surgeon’s palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

키워드

Determination; Lymph node; Metastasis; Palpation; Surgeon

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