Original communication| Volume 113, ISSUE 5, P541-544, May 1993

Download started.


Clinical evaluation of upper mediastinal dissection for differentiated thyroid carcinoma

      This paper is only available as a PDF. To read, Please Download here.


      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Clark OH
        Thyroid nodules and thyroid cancer.
        in: Clark OH Endocrine surgery of the thyroid and parathyroid glands. CV Mosby, St. Louis1985: 56-90
        • Edis AJ
        • Ayula LA
        • Egdahl RH
        1st ed. Manual of endocrine surgery. Springer-Verlag, New York1975: 77-86
      1. Lindsay S Carcinoma of the thyroid gland. Charles C Thomas, Springfield, Illinois1960: 79-89
        • Pollack RSP
        Cervical lymph node metastasis of thyroid cancer.
        Am J Surg. 1961; 102: 389-394
        • McClintock JC
        • Stranahan A
        • Alley RD
        • Baker WA
        A thoracocervical approach for malignant disease to the thyroid gland.
        Ann Surg. 1954; 2: 158-165
        • McCorkle HJ
        The surgical removal of metastatic malignant disease of the thyroid gland from the anterior-superior mediastinum.
        Am J Surg. 1957; 94: 217-222
        • Sisson GA
        • Feldman DE
        The management of thyroid carcinoma metastatic to the neck and mediastinum.
        Otolaryngol Clin North Am. 1980; 13: 119-126
        • Cady B
        Surgery of thyroid cancer.
        World J Surg. 1981; 5: 3-14
        • Harwood J
        • Clark OH
        • Dunphy JE
        Significance of lymph node metastasis in differentiated thyroid cancer.
        Am J Surg. 1978; 136: 107-112
        • Sisson GA
        • Edison BD
        • Bytell DE
        Transsternal radical neck dissection.
        Arch Otolaryngol. 1975; 101: 46-49
        • Roka R
        • Niederle B
        • Fritch A
        Die transcervicale und transsternale Dissektion des Mediastinums beim Carcinom der Shilddrüse.
        Langenbecks Arch Chir. 1983; 359: 5-17
        • Sheline GE
        • Miller ER
        Studies with radioiodine. VI. Evaluation of radioiodine treatment of carcinoma of the thyroid based on experience at the University of California from 1938 to 1954.
        Radiology. 1957; 69: 527-545
        • Block MA
        • Miller JM
        • Horn Jr, RC
        Significance of mediastinal lymph node metastases in carcinoma of the thyroid.
        Am J Surg. 1972; 123: 702-705
      2. Ackerman LV Cancer. CV Mosby, St. Louis1954: 476-479
        • Massin JP
        • Savoie JC
        • Garnier H
        • Guiraudon G
        • Leger FA
        • Bacourt F
        Pulmonary metastases in differentiated thyroid carcinoma: study of fifty-eight cases with implications for the primary tumor treatment.
        Cancer. 1984; 53: 982-992