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Abstract
Background. An extensive upper mediastinal dissection in advanced differentiated thyroid carcinoma
is occasionally required. This investigation was undertaken to clarify the indications
for mediastinal lymph node dissection and the route of upper mediastinal metastases.
Methods. Twenty-one patients with differentiated thyroid cancer, who underwent their first
radical operations with mediastinal dissection through a partial midline sternotomy,
were enrolled in this study. Of 21 patients, 10 (48%) were found to have mediastinal
lymph node metastases.
Results. The tumor size in the group with metastatic disease was much bigger than that in
the group without metastatic disease. Histologic type and age were similar between
the two groups. The extent of cervical lymph node metastases was more significant
in the group with metastatic disease; in particular, all 10 patients showed more than
two metastatic nodes along the internal jugular vein of the tumor-free side.
Conclusions. This study indicates that metastases to the internal jugular chain on the side contralateral
to the primary tumor would be an extremely important factor for indication of extensive
upper mediastinal lymph node dissection after median partial sternotomy in patients
with differentiated thyroid carcinoma.
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Article info
Publication history
Accepted:
February 1,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
