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.
Dralle, Henning; Damme, Iris; Scheumann, Georg Friedrich Wilhelm; Kotzerke, Jorg; and Kupsch, Eckhart
"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
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol40/iss3/28