Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer

  • Kim, Wan Wook (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Lee, Jeeyeon (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Jung, Jin Hyang (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Park, Ho Yong (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Kim, Won Hwa (Department of Radiology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Kim, Hye Jung (Department of Radiology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Park, Ji-Young (Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Tufano, Ralph P. (Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine)
  • Received : 2020.03.04
  • Accepted : 2020.04.07
  • Published : 2020.10.31
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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.

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References

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