Incidence and Significance of Delphian Node Metastasis in Papillary Thyroid Cancer
- 1 May 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 253 (5), 988-991
- https://doi.org/10.1097/sla.0b013e31821219ca
Abstract
The objective of this study was to determine the incidence and significance of Delphian node (DN) metastasis in papillary thyroid cancer. Despite the historic association, the prognostic implications of thyroid cancer metastasis to the DN remain unclear. Retrospective analysis of 101 patients who underwent thyroid surgery from 2007 to 2009 for papillary thyroid cancer, and had their DN harvested ab initio. Of these, 25 had metastatic disease to the DN. DN status was correlated with clinical and pathologic factors including age, gender, tumor size, histologic variant, extra-thyroidal extension (ETE), and central and lateral nodal metastasis. DN positivity was seen consequent to higher rates of ETE of the primary tumor (52% vs. 28%; P = 0.025) and is associated with further nodal metastases to the central (72% vs. 22%; P < 0.0001) and lateral (28% vs. 4%; P < 0.0001) neck compartments. DN positivity was also associated with heavier nodal burden, in terms of number of metastatic nodes (median 5 vs. 2 nodes; P = 0.005) and nodal size (median 1 cm vs. 0.5 cm; P = 0.03). Metastatic involvement of the DN is often associated with ETE and increased incidence of metastatic disease to the central and lateral neck compartments. If the DN is positive on intraoperative frozen section, careful evaluation of the central and lateral nodal compartments is essential.Keywords
This publication has 16 references indexed in Scilit:
- Supracricoid partial laryngectomy with cricohyoidoepiglottopexy in patients with radiation therapy failureWorld Journal of Surgical Oncology, 2009
- Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid CancerThyroid®, 2009
- Selective Surgical Management of Well‐Differentiated Thyroid CancerAnnals of the New York Academy of Sciences, 2008
- The Delphian Lymph Node in Thyroid CancerAnnals of Surgery, 2008
- Treatment of thyroid cancer based on risk groupsJournal of Surgical Oncology, 2006
- Evaluation of cervical lymph node metastasis of 1400 patients with cancer of the larynxAuris Nasus Larynx, 2001
- Delphian Lymph Node in Laryngeal Carcinoma: A Whole Organ StudyThe Laryngoscope, 1997
- Impact of lymph node metastasis in differentiated carcinoma of the thyroid: A matched-pair analysisHead & Neck, 1996
- Patterns of failure after total laryngectomy for glottic carcinomaCancer, 1989
- Positive delphian lymph node: Clinical significance in laryngeal cancerThe Laryngoscope, 1987