Comparative Results of Modified Radical Neck Dissection and Level I Preserving Selective Neck Dissection for Metastatic Papillary Carcinoma of the Thyroid

Chang, Myung Chul; Oh, Seung Keun

Abstract

PURPOSE: The level I lymph node group is not a usual drainage site for papillary carcinoma of the thyroid. Dissection of the level I lymph nodes may result in injury to the marginal mandibular branch of the facial nerves and the submandibular gland. The aim of this study was to clarify the possibility of a conservative neck dissection without performing a level I dissection.
METHODS
From January 1985 to December 1989 a total of 244 patients underwent an operation for papillary carcinoma of the thyroid at Seoul National University Hospital. Eighty-two out of 244 patients who had palpable lateral cervical nodes were treated by a modified radical neck dissection. Between January 1985 and December 1986, a level I dissection was performed. However, in the latter three years, selective neck dissection that preserved the level I lymph nodes was carried out. Thirty-three patients who underwent a classical modified radical neck dissection were compared with 49 patients who underwent a selective neck dissection without a level I dissection.
RESULTS
There were no differences in gender and the extent of disease between the groups. One case of injury to the marginal mandibular branch of the facial nerve occurred in the level I dissected group. There were no differences in the recurrence rate and survival rate.
CONCLUSION
We concluded that a level I lymph node dissection is not necessary in a modified radical neck dissection for treating metastatic papillary carcinoma of the thyroid.