Frequency of lymph node metastasis in differentiated thyroid carcinoma

Background: Although lymphatic metastasis does not affect overall survival for patients with differentiated thyroid carcinoma, locoregional control can be improved with cervical lymphadenectomy. The major morbidity of neck dissection (ND) for the management of regional metastasis is spinal accessory (CN XI) dysfunction. To avoid this complication, some surgeon advocates limited ND. This study aimed to analyze the frequency of lymph node metastasis in differentiated carcinoma of the thyroid. Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology, Rajshahi Medical College Hospital, Rajshahi, and Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU), from July 2011 to Jun 2012. A total of 40 patients were selected as study subjects by simple random sampling technique. A descriptive analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows. Results: In this study, a majority 35 (87.5%) of the patients suffered from papillary carcinoma, followed by 5 (12.5%) follicular carcinoma It was found that 18 (51.43%) patients had lymph node metastasis from papillary carcinoma of the thyroid. 10 (55.56%), and 4 (22.22%) patients had right and left-sided lymph node involvement respectively. Bilateral involvement was found in 4 (22.22%) patients. The predominant site of metastasis was level-III (77.3%) followed by level-VI (63.64%) nodal metastasis. Conclusions: This study concludes that metastasis in differentiated thyroid carcinoma is common. Lymph node metastasis is more common in papillary carcinoma than follicular carcinoma.