Frequency and Significance of Cervicomediastinal Lymph Node Metastases in Medullary Thyroid Carcinoma: Results of a Compartment-Oriented Microdissection Method

Authors

Henning Dralle
Iris Damme
Georg Friedrich Wilhelm Scheumann
Jorg Kotzerke
Eckhart Kupsch

Abstract

The frequency and significance of cervicomediastinal lymph node metastases have been investigated in 82 medullary thyroid carcinoma (MTC) patients retrospectively comparing two surgical techniques of lymph node dissection: selective lymphadenectomy (n = 63) versus compartment-oriented microdissection (n = 35). No positive correlation was observed between primary tumor size and the number of lymph node metastases. Inpatients with lymph node metastases proven histologically, 42% showed only cervical involvement (35% unilateral—type A, 7% bilateral—type B, and 22% cervicomediastinal lymph node involvement (15% cervico-unilateral and mediastinal—type C, 7% cervicobilateral and mediastinal—type D). Biochemical cure was 83% in node-negative patients but only 21% in node-positive patients. In node-positive MTC, calcitonin normalization was achieved in none with bilateral lymph node involvement but only in those unilateral lymph node metastases (31% in type A, 17% in type C). Survival and biochemical cure are significantly improved by application of the compartment-oriented microdissection method more so at primary surgery than at reoperation.

Recommended Citation

Dralle, Henning; Damme, Iris; Scheumann, Georg Friedrich Wilhelm; Kotzerke, Jorg; and Kupsch, Eckhart (1992) "Frequency and Significance of Cervicomediastinal Lymph Node Metastases in Medullary Thyroid Carcinoma: Results of a Compartment-Oriented Microdissection Method," Henry Ford Hospital Medical Journal : Vol. 40 : No. 3 , 264-267.
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol40/iss3/28