Dana M Hartl, Davide Lombardi, Ricard Simo, Radu Mihai, Aleix Rovira, Enyi Ofo, Iain J Nixon
{"title":"超超选择水平VB颈部清扫术治疗甲状腺乳头状癌。","authors":"Dana M Hartl, Davide Lombardi, Ricard Simo, Radu Mihai, Aleix Rovira, Enyi Ofo, Iain J Nixon","doi":"10.3390/cancers17091497","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic lateral neck dissection is recommended for papillary thyroid cancer with metastatic lymph nodes detected on palpation or on preoperative imaging. Current guidelines recommend systematic dissection of levels IIA, III, IV and VB in these patients. Despite this recommendation, management of level V remains controversial due to a varying degree of clinical and occult lymph node involvement reported in published retrospective studies, but also due to the functional risk involved in level V dissection in which the spinal accessory nerve may be temporarily or permanently injured. The aim of this review was to address the issues involved in level VB dissection and to provide our view of surgical management of level VB.</p><p><strong>Method: </strong>Narrrative review.</p><p><strong>Result: </strong>We propose a new concept of a partial or \"<i>super</i>-superselective\" level VB dissection in patients with clinical disease in levels IIA, III and IV.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 9","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070824/pdf/","citationCount":"0","resultStr":"{\"title\":\"<i>Super</i>-Superselective Level VB Neck Dissection for Papillary Thyroid Cancer.\",\"authors\":\"Dana M Hartl, Davide Lombardi, Ricard Simo, Radu Mihai, Aleix Rovira, Enyi Ofo, Iain J Nixon\",\"doi\":\"10.3390/cancers17091497\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Therapeutic lateral neck dissection is recommended for papillary thyroid cancer with metastatic lymph nodes detected on palpation or on preoperative imaging. Current guidelines recommend systematic dissection of levels IIA, III, IV and VB in these patients. Despite this recommendation, management of level V remains controversial due to a varying degree of clinical and occult lymph node involvement reported in published retrospective studies, but also due to the functional risk involved in level V dissection in which the spinal accessory nerve may be temporarily or permanently injured. The aim of this review was to address the issues involved in level VB dissection and to provide our view of surgical management of level VB.</p><p><strong>Method: </strong>Narrrative review.</p><p><strong>Result: </strong>We propose a new concept of a partial or \\\"<i>super</i>-superselective\\\" level VB dissection in patients with clinical disease in levels IIA, III and IV.</p>\",\"PeriodicalId\":9681,\"journal\":{\"name\":\"Cancers\",\"volume\":\"17 9\",\"pages\":\"\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-04-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070824/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancers\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/cancers17091497\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancers","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/cancers17091497","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Super-Superselective Level VB Neck Dissection for Papillary Thyroid Cancer.
Objective: Therapeutic lateral neck dissection is recommended for papillary thyroid cancer with metastatic lymph nodes detected on palpation or on preoperative imaging. Current guidelines recommend systematic dissection of levels IIA, III, IV and VB in these patients. Despite this recommendation, management of level V remains controversial due to a varying degree of clinical and occult lymph node involvement reported in published retrospective studies, but also due to the functional risk involved in level V dissection in which the spinal accessory nerve may be temporarily or permanently injured. The aim of this review was to address the issues involved in level VB dissection and to provide our view of surgical management of level VB.
Method: Narrrative review.
Result: We propose a new concept of a partial or "super-superselective" level VB dissection in patients with clinical disease in levels IIA, III and IV.
期刊介绍:
Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.