Incidence and significance of delphian node metastasis in papillary thyroid cancer Journal Article


Authors: Iyer, N. G.; Kumar, A.; Nixon, I. J.; Patel, S. G.; Ganly, I.; Tuttle, R. M.; Shah, J. P.; Shaha, A. R.
Article Title: Incidence and significance of delphian node metastasis in papillary thyroid cancer
Abstract: Objective: The objective of this study was to determine the incidence and significance of Delphian node (DN) metastasis in papillary thyroid cancer. Summary of Background Data: Despite the historic association, the prognostic implications of thyroid cancer metastasis to the DN remain unclear. Methods: 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. Results: 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). Conclusions: 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. © 2011 Lippincott Williams & Wilkins.
Keywords: adult; controlled study; human tissue; primary tumor; major clinical study; histopathology; lymph node metastasis; cancer incidence; tumor volume; thyroid papillary carcinoma
Journal Title: Annals of Surgery
Volume: 253
Issue: 5
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2011-05-01
Start Page: 988
End Page: 991
Language: English
DOI: 10.1097/SLA.0b013e31821219ca
PROVIDER: scopus
PUBMED: 21372688
DOI/URL:
Notes: --- - "Export Date: 23 June 2011" - "CODEN: ANSUA" - "Source: Scopus"
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MSK Authors
  1. Ashok R Shaha
    697 Shaha
  2. Snehal G Patel
    412 Patel
  3. Robert M Tuttle
    481 Tuttle
  4. Narayanan Gopalakrishna Iyer
    16 Iyer
  5. Iain James Nixon
    60 Nixon
  6. Ian Ganly
    430 Ganly
  7. Jatin P Shah
    721 Shah
  8. Anumeha Kumar
    1 Kumar