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• W2535562783 startingPage "253" @default.
• W2535562783 abstract "Background: For N1b papillary thyroid carcinoma (PTC) patients, modified radical neck dissection (MRND) encompassing levels II–V is generally recommended. However, routine level V dissection is controversial because of the low incidence of metastasis/recurrence in level V and the increased morbidities associated with level V dissection. Methods: This study retrospectively reviewed 646 N1b PTC patients who underwent unilateral MRND between January 1997 and June 2015. Specifically, to assess surgery-related outcomes of level V dissection, outcomes from N1b PTC patients who underwent unilateral MRND (levels II–V) were compared with those who underwent unilateral selective neck dissection (SND; levels II–IV) using propensity score matching. Results: Overall and occult level V metastases were observed in 13.9% and 8.6% of patients, respectively. Level V recurrences were observed in only 2.26 (7.7%) recurred N1b PTC patients who underwent unilateral MRND. In multivariate analysis, three-level (II, III, and IV) simultaneous metastasis (adjusted odds ratio = 3.079, p = 0.003) was an independent predictor for level V metastasis. Under a matched condition, “shoulder syndrome” encompassing shoulder dysfunction and pain (9.1% vs. 2.7%, p = 0.002) was significantly more frequent in the MRND group than it was in the SND group. Conclusions: Because of the low incidence of metastasis/recurrence in level V and the clear evidence of increased morbidities, level V dissection in N1b PTC patients may be reserved for those with three-level simultaneous metastasis or clinically/radiologically evident level V metastasis." @default.
• W2535562783 created "2016-10-28" @default.
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• W2535562783 date "2017-02-01" @default.
• W2535562783 modified "2023-10-16" @default.
• W2535562783 title "Should Level V Be Routinely Dissected in N1b Papillary Thyroid Carcinoma?" @default.
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• W2535562783 doi "https://doi.org/10.1089/thy.2016.0364" @default.
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• W2535562783 hasPublicationYear "2017" @default.
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