J.Jpn. Surg. Soc.. 91(2): 255-261, 1990

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Original article

CLINICAL EVALUATION OF EXTENDED NECK DIFFERENTIATED THYROID CARCINOMA

In some patients with advanced differentiated thyroid carcinoma, an upper mediastinal dissection is recommended. Both 17 primary and 6 non-primary patients who had undergone an upper mediastinal dissection in Shinshu University Hospital, from 1984 to 1987, were surveyed. We also studied 198 patients who had been performed a modified radical neck dissection from 1984 to 1986.
In the 17 primary cases, 6 (35%) had positive nodes in the upper mediastinum (M group), and 11 (65%) negative (NM group). And we analysed these two groups. In addition,5non-primary cases and 198 patients were analyzed in terms of the nodal metastatic status of the tumor-free side. From these results, we conclude the indication of mediastinal dissection for thyroid carcinoma as follows : ① positive lymph node is suspected in the upper mediastinum by the study of CT or ²⁰¹thallium scintigram. ② nodal metastases are suspected in the deep cervical location of the tumor-free side. ③ a male patient whose age is younger than 50, and tumor is located in the left lobe and its size is larger than 3.0cm.

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